Provider Demographics
NPI:1659662864
Name:DESAI, LAVANYA (RPH)
Entity Type:Individual
Prefix:
First Name:LAVANYA
Middle Name:
Last Name:DESAI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3581 DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-8807
Mailing Address - Country:US
Mailing Address - Phone:919-460-8577
Mailing Address - Fax:919-460-4418
Practice Address - Street 1:3581 DAVIS DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-8807
Practice Address - Country:US
Practice Address - Phone:919-460-8577
Practice Address - Fax:919-460-4418
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC161521835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy