Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | K0018 | TX |
Y | 111NI0900X | Internist | K0018 | TX |
N | 207RA0201X | Internist - Allergy & Immunology | K0018 | TX |
N | 207RR0500X | Rheumatology | K0018 | TX |
NPI | 1689809535 |
---|---|
Provider Name | Dr. Ketan Desai |
First Address | Easton, PA 18040-8261 |
Second Address | Easton, PA 18040-8261 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2009 |
Last Update Date | 13/07/2009 |