Provider Demographics
NPI:1497363592
Name:PANDYA, DESHANKI NAISHAD (MD)
Entity Type:Individual
Prefix:DR
First Name:DESHANKI
Middle Name:NAISHAD
Last Name:PANDYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:831 TENNENT RD STE 1E
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8288
Practice Address - Country:US
Practice Address - Phone:732-851-0200
Practice Address - Fax:732-617-5916
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA11938900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine