Basic Information
| Provider Information | |||||||||
| NPI: | 1629181987 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DESAI | ||||||||
| FirstName: | RONAK | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 FEDERAL ST | ||||||||
| Address2: | SUITE SW200 | ||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031088 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 COOPER PLZ | ||||||||
| Address2: | COOPER ANESTHESIA ASSOCIATES | ||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563422425 | ||||||||
| FaxNumber: | 8569688326 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2006 | ||||||||
| LastUpdateDate: | 04/14/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MB081075 | NJ | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 010077990 | 01 | NJ | AMERICHOICE | OTHER | 0112267 | 05 | NJ | MEDICAID | 60026881 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 7201586 | 01 | NJ | CIGNA | OTHER | 1353930 | 01 | NJ | AETNA | OTHER | 2816926 | 01 | NJ | UNITED HEALTH CARE | OTHER | 1355564 | 01 | NJ | AETNA | OTHER | 2778677000 | 01 | NJ | AMERIHEALTH/KEYSTONE/IBC | OTHER | 60026882 | 01 | NJ | HORIZON NJ HEALTH | OTHER |