| Manikant V. Desai, Md, Pc | |
|
101 W Broad St 5th Floor; Suite 508 Hazleton PA 18201-6303 | |
| (570) 454-1056 | |
| (570) 454-3995 |
| Full Name | Manikant V. Desai, Md, Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 101 W Broad St, Hazleton, Pennsylvania |
| Authorized Official Name and Position | Manikant V Desai (CEO) |
| Authorized Official Contact | 5704541056 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Manikant V. Desai, Md, Pc 101 W Broad St 5th Floor; Suite 508 Hazleton PA 18201-6303 Ph: (570) 454-1056 | Manikant V. Desai, Md, Pc 101 W Broad St 5th Floor; Suite 508 Hazleton PA 18201-6303 Ph: (570) 454-1056 |
| NPI Number | 1417054206 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417054206 | NPI | - | NPPES |
| 0005535200006 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD036585L (Pennsylvania) | Primary |
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