Provider Demographics
NPI:1003092453
Name:DESAI, MILI G (RD, CDN)
Entity Type:Individual
Prefix:
First Name:MILI
Middle Name:G
Last Name:DESAI
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 MAIDEN LN FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4073
Mailing Address - Country:US
Mailing Address - Phone:917-742-8156
Mailing Address - Fax:
Practice Address - Street 1:5676 RIVERDALE AVE STE 300
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-2100
Practice Address - Country:US
Practice Address - Phone:917-742-8156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY953851133V00000X
NY006075133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered