Provider Demographics
NPI:1578643193
Name:DESAI, HEMLATA KIRITKUMAR (MD)
Entity Type:Individual
Prefix:MRS
First Name:HEMLATA
Middle Name:KIRITKUMAR
Last Name:DESAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 KNOX DR
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-4423
Mailing Address - Country:US
Mailing Address - Phone:215-493-0477
Mailing Address - Fax:
Practice Address - Street 1:ROUTE 72
Practice Address - Street 2:
Practice Address - City:NEW LISBON
Practice Address - State:NJ
Practice Address - Zip Code:08064
Practice Address - Country:US
Practice Address - Phone:609-726-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05166700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE67638Medicare UPIN