Provider Demographics
NPI:1477226827
Name:DESAI, RAVI (PHARMD)
Entity Type:Individual
Prefix:
First Name:RAVI
Middle Name:
Last Name:DESAI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 FITZGERALD ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1100
Mailing Address - Country:US
Mailing Address - Phone:814-289-6191
Mailing Address - Fax:
Practice Address - Street 1:190 WELLES ST STE 128
Practice Address - Street 2:
Practice Address - City:FORTY FORT
Practice Address - State:PA
Practice Address - Zip Code:18704-4961
Practice Address - Country:US
Practice Address - Phone:570-714-6635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP454556183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist