Basic Information
Provider Information | |||||||||
NPI: | 1548428618 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | DESAI | ||||||||
FirstName: | ALPA | ||||||||
MiddleName: | G | ||||||||
NamePrefix: | MS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 29 PETER LN | ||||||||
Address2: |   | ||||||||
City: | NEW HYDE PARK | ||||||||
State: | NY | ||||||||
PostalCode: | 110401834 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6314443869 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | HSC 17 040 | ||||||||
Address2: | DIVISION OF PULMONARY, CRITICAL CARE AND SLEEP MEDICINE | ||||||||
City: | STONY BROOK | ||||||||
State: | NY | ||||||||
PostalCode: | 117948172 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6314443869 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/27/2008 | ||||||||
LastUpdateDate: | 05/10/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 05/10/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | 239338 | NY | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | 239338 | NY | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.