Provider Demographics
NPI:1225140445
Name:DESAI, BHARATI C (MD)
Entity Type:Individual
Prefix:MRS
First Name:BHARATI
Middle Name:C
Last Name:DESAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BHARATI
Other - Middle Name:R
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:229 ALL ANGELS HILL RD
Mailing Address - Street 2:
Mailing Address - City:WAPPINGER FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590
Mailing Address - Country:US
Mailing Address - Phone:845-297-4064
Mailing Address - Fax:845-297-0120
Practice Address - Street 1:229 ALL ANGELS HILL RD
Practice Address - Street 2:
Practice Address - City:WAPPINGER FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590
Practice Address - Country:US
Practice Address - Phone:845-297-4064
Practice Address - Fax:845-297-0120
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY137408207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00242966Medicaid
B79210Medicare UPIN
74A761Medicare ID - Type Unspecified