Provider Demographics
NPI:1083889968
Name:DESAI, JAY C (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:C
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CAZENOVE ST
Mailing Address - Street 2:APT 104
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-6234
Mailing Address - Country:US
Mailing Address - Phone:781-710-0777
Mailing Address - Fax:
Practice Address - Street 1:423 EAST 23RD STREET
Practice Address - Street 2:VA NY HARBOR HEALTHCARE SYSTEM
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010
Practice Address - Country:US
Practice Address - Phone:212-686-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260407207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology