Provider Demographics
NPI:1831483866
Name:DESAI, NEAL (MD)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:
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 1:16521 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4134
Mailing Address - Country:US
Mailing Address - Phone:718-657-1717
Mailing Address - Fax:718-657-7748
Practice Address - Street 1:16521 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4134
Practice Address - Country:US
Practice Address - Phone:718-657-1717
Practice Address - Fax:718-657-7748
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP02273207R00000X
NY281781207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine