Provider Demographics
NPI:1770817991
Name:DESAI, SACHIN N
Entity Type:Individual
Prefix:DR
First Name:SACHIN
Middle Name:N
Last Name:DESAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 208064
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8064
Mailing Address - Country:US
Mailing Address - Phone:203-785-4730
Mailing Address - Fax:203-785-6961
Practice Address - Street 1:2 CHURCH ST S
Practice Address - Street 2:SUITE 300A
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1717
Practice Address - Country:US
Practice Address - Phone:203-785-4758
Practice Address - Fax:203-785-6961
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT99999999992080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases