Provider Demographics
NPI:1659951044
Name:DESAI, NIYATI TUSHARBHAI (MBBS, MD)
Entity Type:Individual
Prefix:
First Name:NIYATI
Middle Name:TUSHARBHAI
Last Name:DESAI
Suffix:
Gender:F
Credentials:MBBS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 E SQUANTUM ST APT 4
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-2261
Mailing Address - Country:US
Mailing Address - Phone:617-849-1609
Mailing Address - Fax:
Practice Address - Street 1:89 E SQUANTUM ST APT 4
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-2261
Practice Address - Country:US
Practice Address - Phone:617-849-1609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-10
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program