Desai, Gautam T
Desai, Gautam T is an individual health care provider with primary practice located at 447 Rt 10 Suite 2, Randolph NJ 07869. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Desai, Gautam T can be contacted via phone (973) 361-4555.Contact Information
Primary practice address
447 Rt 10 Suite 2
Randolph NJ 07869
Phone: (973) 361-4555
Fax: (973) 361-6360
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 25MA03468300 | New Jersey |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 25MA03468300 | New Jersey |
Profile Details
| NPI number | 1639116742 |
|---|---|
| LBN Legal business name | Desai, Gautam T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639116742 | NPPES |
| New Jersey | MEDICAID | 2982803 |
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