Provider Demographics
NPI:1891013595
Name:DESAI, BHAVANA KUNJ (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BHAVANA
Middle Name:KUNJ
Last Name:DESAI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SURRY CT
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-5504
Mailing Address - Country:US
Mailing Address - Phone:201-763-6182
Mailing Address - Fax:
Practice Address - Street 1:20 ASTOR PLACE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6903
Practice Address - Country:US
Practice Address - Phone:212-375-0734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050932183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist