Provider Demographics
NPI:1740255603
Name:DESAI, BASAVARAJ VEERANNA (MD)
Entity type:Individual
Prefix:DR
First Name:BASAVARAJ
Middle Name:VEERANNA
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:39 BRENTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8031
Mailing Address - Country:US
Mailing Address - Phone:631-591-7400
Mailing Address - Fax:631-591-7401
Practice Address - Street 1:39 BRENTWOOD RD STE 101
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706
Practice Address - Country:US
Practice Address - Phone:631-591-7400
Practice Address - Fax:631-591-7401
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2019-09-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK5897207RC0000X
NY1826741207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease