Provider Demographics
NPI:1639314362
Name:DESAI, KRUPA (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KRUPA
Middle Name:
Last Name:DESAI
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 GARDEN CIR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-4803
Mailing Address - Country:US
Mailing Address - Phone:516-496-4418
Mailing Address - Fax:
Practice Address - Street 1:52 GARDEN CIR
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4803
Practice Address - Country:US
Practice Address - Phone:516-496-4418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011443-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist