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NPI 1932102589

NPI 1932102589 : ROBERT A DESIMONE M.D. : FLORHAM PARK, NJ

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General NPI Number Information
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    NPI Number           |    1932102589
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERT A DESIMONE M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/27/2005
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    Last Update Date     |    03/18/2025
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Provider Practice Location Address
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    Address Line         |    254 COLUMBIA TPKE 
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    City                 |    FLORHAM PARK
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    State                |    NJ
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    Zip                  |    07932-1222
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    Country              |    US
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    Telephone            |    973-625-6000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 508 
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    City                 |    MONTVILLE
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    State                |    NJ
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    Zip                  |    07045-0508
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    Country              |    US
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    Telephone            |    973-886-2195
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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        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    ME113643
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    License Number State |    FL
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Taxonomy #2
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    Taxonomy Code        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    25MA05633700
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    License Number State |    NJ
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