Active NPI
Renuka Desai, M.D.
- Pediatrics Physician
- Sewell, NJ
National Provider Identifier
1245324862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MA03605600
- Practice address
- 123 Egg Harbor Rd
Tower Commons Ste 206
Sewell, NJ 08080-9406 - Phone
- (856) 227-5437
- Fax
- (856) 227-5890
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25MA03605600 | NJ | Primary |
Addresses
Primary practice location
123 Egg Harbor Rd
Tower Commons Ste 206
Sewell, NJ 08080-9406
Mailing address
402 Lippincott Dr
Marlton, NJ 08053-4112
Phone (856) 782-3300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA03605600 | NJ | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269820800000",
"number": "1245324862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 LIPPINCOTT DR",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080534112",
"telephone_number": "856-782-3300",
"fax_number": "856-504-8029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 EGG HARBOR RD",
"address_2": "TOWER COMMONS STE 206",
"city": "SEWELL",
"state": "NJ",
"postal_code": "080809406",
"telephone_number": "856-227-5437",
"fax_number": "856-227-5890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESAI",
"first_name": "RENUKA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2010-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA03605600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sewell, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.