Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 210284 | NY |
NPI | 1003892902 |
---|---|
Provider Name | Dr. Ninad Desai |
First Address | Great Neck, NY 11024-2026 |
Second Address | Brooklyn, NY 11203-2057 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01905706 | (05) | NY |