Healthcare Provider Details

I. General information

NPI: 1780067827
Provider Name (Legal Business Name): DESAIMD MEDICAL ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 07/07/2021
Certification Date: 07/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1296 QUARRY COMMONS DR
YARDLEY PA
19067-4028
US

IV. Provider business mailing address

1296 QUARRY COMMONS DR
YARDLEY PA
19067-4028
US

V. Phone/Fax

Practice location:
  • Phone: 215-321-0986
  • Fax:
Mailing address:
  • Phone: 215-423-4005
  • Fax: 215-423-4006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD418804
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. NARENDRA DESAI
Title or Position: PRESIDENT
Credential: MD
Phone: 215-423-4005