Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 057750 | NY |
NPI | 1144616699 |
---|---|
Provider Name | Dr. Anita Sunil Desai |
First Address | Pittsburgh, PA 15232-1213 |
Second Address | Pittsburgh, PA 15232-1213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2015 |
Last Update Date | 11/04/2015 |