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NPI Code Detail

MEDICARE: DR. MOHAN SAKHARAM DESHPANDE M.D.

MEDICARE: DR. MOHAN SAKHARAM DESHPANDE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease PhysicianMA032698NJ

General Provider Information

NPI Number : 1134101934
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MOHAN SAKHARAM DESHPANDE M.D.
Provider Business Mailing Address
First Line : 806 KEARNY AVE
Second Line :
City : KEARNY
State : NJ
Zip : 07032-3148
Country : US
Telephone Number : 201-997-8806
Fax Number :
Provider Business Practice Location Address
First Line : 806 KEARNY AVE
Second Line :
City : KEARNY
State : NJ
Zip : 07032-3148
Country : US
Telephone Number : 201-997-8806
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2005
Last Update Date : 06/28/2010

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