Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 25MA10655300 | NJ |
NPI | 1093102006 |
---|---|
Provider Name | Anil Desai |
First Address | Hackensack, NJ 07601-1962 |
Second Address | Hackensack, NJ 07601-1962 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2015 |
Last Update Date | 23/10/2019 |