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General NPI Number Information
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NPI Number | 1194761593
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Entity Type | Individual
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Provider Name | JAGDIP DESAI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 1 CLARA MAASS DR ANESTHESIA DEPARTMENT
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City | BELLEVILLE
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State | NJ
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Zip | 07109-3550
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Country | US
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Telephone | 908-705-6857
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Fax |
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Provider Business Mailing Address
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Address Line | 51 RARITAN REACH RD
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City | SOUTH AMBOY
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State | NJ
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Zip | 08879-3440
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Country | US
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Telephone | 732-709-3215
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Fax | 908-994-5061
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MA07787200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 25MA07787200
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License Number State | NJ
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