Provider Demographics
NPI:1588238406
Name:JIANG, DESAI VICTOR (MD)
Entity Type:Individual
Prefix:MR
First Name:DESAI
Middle Name:VICTOR
Last Name:JIANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:DESAI
Other - Middle Name:
Other - Last Name:JIANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:425 JACK MARTIN BLVD. OCEAN UNIVERSITY MEDICAL CENTER
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724
Mailing Address - Country:US
Mailing Address - Phone:732-840-2200
Mailing Address - Fax:516-572-5609
Practice Address - Street 1:425 JACK MARTIN BLVD. OCEAN UNIVERSITY MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724
Practice Address - Country:US
Practice Address - Phone:732-840-2200
Practice Address - Fax:516-572-5609
Is Sole Proprietor?:No
Enumeration Date:2021-05-15
Last Update Date:2024-02-16
Deactivation Date:2022-09-27
Deactivation Code:
Reactivation Date:2022-11-16
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program