Provider Demographics
NPI:1073864732
Name:DESAI, APEXA (RPA-C)
Entity Type:Individual
Prefix:
First Name:APEXA
Middle Name:
Last Name:DESAI
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8853 RANSOM ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2723
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:210 E 86TH ST
Practice Address - Street 2:502
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-3003
Practice Address - Country:US
Practice Address - Phone:212-744-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015856363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant