Gautam J Desai, M.D.
Internal Medicine in West Long Branch, NJ. Individual provider (NPI-1).
NPI number1245242510
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1245242510
- Entity type
- Individual (NPI-1)
- Name
- Gautam J Desai
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 13, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | MA07111300 | NJ | Yes |
Practice location
842 BroadwayWest Long Branch, NJ 07764-1503
Phone 732-222-0180 · Fax 732-222-3990
Mailing address
842 BroadwayWest Long Branch, NJ 07764-1503
Phone 732-222-0180 · Fax 732-222-3990
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