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NPI Code Detail

MEDICARE: NEELAM SAMIT DESAI

MEDICARE: NEELAM SAMIT DESAI
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
1225100000XPhysical TherapistP13443NC

General Provider Information

NPI Number : 1376958082
Entity Type Code : Individual
Provider Name (Legal Business Name) : NEELAM SAMIT DESAI
Provider Business Mailing Address
First Line : 14420 BALLANTYNE LAKE RD
Second Line : #328
City : CHARLOTTE
State : NC
Zip : 28277-3385
Country : US
Telephone Number : 408-391-6584
Fax Number :
Provider Business Practice Location Address
First Line : 5800 OLD PROVIDENCE RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28226-6872
Country : US
Telephone Number : 704-365-8551
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2014
Last Update Date : 01/23/2017

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Directions to “ NEELAM SAMIT DESAI ” Practice Location

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