Provider Demographics
NPI:1457588014
Name:DESAI ENDOCRINE ASSOCIATES, PC
Entity Type:Organization
Organization Name:DESAI ENDOCRINE ASSOCIATES, PC
Other - Org Name:FULL CIRCLE ENDOCRINOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAVTIKA
Authorized Official - Middle Name:R
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:908-829-4244
Mailing Address - Street 1:140 TOP OF THE WORLD WAY
Mailing Address - Street 2:
Mailing Address - City:GREEN BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08812-1839
Mailing Address - Country:US
Mailing Address - Phone:609-937-3139
Mailing Address - Fax:
Practice Address - Street 1:105 RAIDER BLVD.
Practice Address - Street 2:SUITE 200
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844
Practice Address - Country:US
Practice Address - Phone:908-829-4244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08065200261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ163732OtherMEDICARE PTAN