Healthcare Provider Details

I. General information

NPI: 1871869511
Provider Name (Legal Business Name): VED DESAI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2012
Last Update Date: 11/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 MORRIS AVE STE 100
SPRINGFIELD NJ
07081
US

IV. Provider business mailing address

PO BOX 416457
BOSTON MA
02241-6457
US

V. Phone/Fax

Practice location:
  • Phone: 973-379-2111
  • Fax: 973-379-2807
Mailing address:
  • Phone: 844-362-1735
  • Fax: 973-290-7495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number25MB10272100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: