MEDICARE: WESTCHESTER AVENUE FAMILY MEDICINE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	251400	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023388428
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTCHESTER AVENUE FAMILY MEDICINE PC

Provider Business Mailing Address
First Line	:	34 INVERNESS CT
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-5113
Country	:	US
Telephone Number	:	606-813-9170
Fax Number	:	718-589-7952

Provider Business Practice Location Address
First Line	:	1575 WESTCHESTER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-2912
Country	:	US
Telephone Number	:	718-842-8900
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. AJITH KUMAR KARAYIL
Credential	:	M.D.
Telephone Number	:	606-813-9170

Provider Enumeration Date	:	01/03/2012
Last Update Date	:	01/20/2021

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