Provider Demographics
NPI:1356468920
Name:DESAI PHYSICIAN CONSULTING SERVICES
Entity Type:Organization
Organization Name:DESAI PHYSICIAN CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIVRAJ
Authorized Official - Middle Name:JAGDISH
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-520-1395
Mailing Address - Street 1:1501 MOUNT PLEASANT RD
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-2112
Mailing Address - Country:US
Mailing Address - Phone:610-520-1395
Mailing Address - Fax:610-520-1801
Practice Address - Street 1:1501 MOUNT PLEASANT RD
Practice Address - Street 2:
Practice Address - City:VILLANOVA
Practice Address - State:PA
Practice Address - Zip Code:19085-2112
Practice Address - Country:US
Practice Address - Phone:610-520-1395
Practice Address - Fax:610-520-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD0313575E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E64145Medicare UPIN
PA503860Medicare ID - Type Unspecified