Provider Demographics
NPI:1225137797
Name:DESAI, ANJALI A (MD)
Entity Type:Individual
Prefix:DR
First Name:ANJALI
Middle Name:A
Last Name:DESAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:196 GROVE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08086-2139
Practice Address - Country:US
Practice Address - Phone:856-848-7577
Practice Address - Fax:856-848-6554
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD423271207R00000X
NJMA077033207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0081663Medicaid
NJ1713909OtherCIGNA HEALTH PLAN
NJP3597144OtherOXFORD HEALTH PLAN
PA1595039OtherAMERIHEALTH PPO PABS
NJ01000765000OtherAMERICHOICE
NJ3985113OtherAETNA- US HEALTHCARE
NJ3985123OtherAETNA US HEALTHCARE
NJ3K6104OtherHEALTHNET, INC
NJ2272553000OtherAMERIHEALTH HMO
NJ2469030OtherUNITED HEALTHCARE
NJ60021595OtherHORIZON-NJ HEALTH
NJ60021597OtherHORIZON- NJ HEALTH
NJP00298838OtherRAILROAD MEDICARE
NJ01000765000OtherAMERICHOICE
NJ60021595OtherHORIZON-NJ HEALTH