MEDICARE: RAVI DESAI PHARMD

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
1	183500000X	Pharmacist	RP454556	PA

General Provider Information

NPI Number	:	1477226827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAVI DESAI PHARMD

Provider Business Mailing Address
First Line	:	701 FITZGERALD ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-1100
Country	:	US
Telephone Number	:	814-289-6191
Fax Number	:

Provider Business Practice Location Address
First Line	:	190 WELLES ST STE 128
Second Line	:
City	:	FORTY FORT
State	:	PA
Zip	:	18704-4961
Country	:	US
Telephone Number	:	570-714-6635
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2021
Last Update Date	:	07/30/2021

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