Provider Demographics
NPI:1659602985
Name:DESAI, MEGHANA (MEGHANA DESAI)
Entity Type:Individual
Prefix:MRS
First Name:MEGHANA
Middle Name:
Last Name:DESAI
Suffix:
Gender:F
Credentials:MEGHANA DESAI
Other - Prefix:MISS
Other - First Name:MEGHANA
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MEGHANA DESAI
Mailing Address - Street 1:1600 W NEWPORT PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19804-3500
Mailing Address - Country:US
Mailing Address - Phone:302-999-1303
Mailing Address - Fax:302-999-1765
Practice Address - Street 1:1600 W NEWPORT PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19804-3500
Practice Address - Country:US
Practice Address - Phone:302-999-1303
Practice Address - Fax:302-999-1765
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0003214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEA1-0003214OtherSTATE LICENSE NUMBER