Provider Demographics
NPI:1619033487
Name:DESAI, SEEMA RAJESH (MS,RD,LDN,CNSD)
Entity Type:Individual
Prefix:MRS
First Name:SEEMA
Middle Name:RAJESH
Last Name:DESAI
Suffix:
Gender:F
Credentials:MS,RD,LDN,CNSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 BLACK TIE LN
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-6656
Mailing Address - Country:US
Mailing Address - Phone:919-929-0220
Mailing Address - Fax:
Practice Address - Street 1:204 BLACK TIE LN
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-6656
Practice Address - Country:US
Practice Address - Phone:919-929-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL001621133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered