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NPI Code Detail

MEDICARE: MEDHA PATEL DESAI

MEDICARE: MEDHA PATEL 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
1363LF0000XFamily Nurse Practitioner9868CT
2163W00000XRegistered Nurse145723CT

General Provider Information

NPI Number : 1861010811
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEDHA PATEL DESAI
Provider Business Mailing Address
First Line : 215 GEORGETOWN DR
Second Line :
City : GLASTONBURY
State : CT
Zip : 06033-2348
Country : US
Telephone Number : 860-995-8292
Fax Number :
Provider Business Practice Location Address
First Line : 2600 TAMARACK AVE STE 200
Second Line :
City : SOUTH WINDSOR
State : CT
Zip : 06074-5560
Country : US
Telephone Number : 860-646-1157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2020
Last Update Date : 12/11/2025

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Directions to “ MEDHA PATEL DESAI ” Practice Location

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