MEDICARE: ANKURI 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
1	207N00000X	Dermatology Physician	315924	NY
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1851896344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANKURI DESAI

Provider Business Mailing Address
First Line	:	1991 MARCUS AVE STE 300
Second Line	:
City	:	NORTH NEW HYDE PARK
State	:	NY
Zip	:	11042-2058
Country	:	US
Telephone Number	:	516-719-3376
Fax Number	:

Provider Business Practice Location Address
First Line	:	1991 MARCUS AVE STE 300
Second Line	:
City	:	NORTH NEW HYDE PARK
State	:	NY
Zip	:	11042-2058
Country	:	US
Telephone Number	:	516-719-3376
Fax Number	:

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

Provider Enumeration Date	:	03/27/2018
Last Update Date	:	06/16/2022

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Directions to “ ANKURI DESAI ” Practice Location

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