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General NPI Number Information
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NPI Number | 1710645163
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Entity Type | Individual
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Provider Name | BHAVIKA DESAI
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Gender | Female
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Dates
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Enumeration Date | 12/02/2021
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 115 BELMONT AVE
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City | BELLEVILLE
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State | NJ
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Zip | 07109-1993
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Country | US
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Telephone | 973-969-1155
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Fax |
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Provider Business Mailing Address
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Address Line | 10 KIVA ST
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City | ISELIN
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State | NJ
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Zip | 08830-2029
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Country | US
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Telephone | 732-402-9608
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI04218800
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License Number State | NJ
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