Healthcare Provider Details

I. General information

NPI: 1376998377
Provider Name (Legal Business Name): KALPESH JYOTI DESAI PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2016
Last Update Date: 04/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 ABBOTT HALL, UNIVERSITY AT BUFFALO SUNY
BUFFALO NY
14214
US

IV. Provider business mailing address

160 N 7TH ST
LEWISTON NY
14092-1306
US

V. Phone/Fax

Practice location:
  • Phone: 716-829-5779
  • Fax:
Mailing address:
  • Phone: 716-405-7453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number047652-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: