Provider Demographics
NPI:1861496457
Name:DESAI, SUNIT B (MD)
Entity Type:Individual
Prefix:
First Name:SUNIT
Middle Name:B
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 HIGHWAY 36 STE 101
Mailing Address - Street 2:
Mailing Address - City:UNION BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:07735-3366
Mailing Address - Country:US
Mailing Address - Phone:732-856-5299
Mailing Address - Fax:732-615-0865
Practice Address - Street 1:809 HIGHWAY 36 STE 101
Practice Address - Street 2:
Practice Address - City:UNION BEACH
Practice Address - State:NJ
Practice Address - Zip Code:07735-3366
Practice Address - Country:US
Practice Address - Phone:973-206-9340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07780100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0047449Medicaid
NJ085744DE4OtherMEDICARE
NJI21604Medicare UPIN