Provider Demographics
NPI:1265495113
Name:DESAI, NARENDRA B (MD)
Entity Type:Individual
Prefix:DR
First Name:NARENDRA
Middle Name:B
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 1:1296 QUARRY COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-4028
Mailing Address - Country:US
Mailing Address - Phone:215-321-0986
Mailing Address - Fax:215-707-0514
Practice Address - Street 1:1296 QUARRY COMMONS DR
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-4028
Practice Address - Country:US
Practice Address - Phone:215-321-0986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD418804207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA057356Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID
PAH65250Medicare UPIN