MEDICARE: DR. ASHOK NIGAM M.D.

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	2085N0904X	Nuclear Radiology Physician	128699	NY
2	2085R0202X	Diagnostic Radiology Physician	128699	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	3000118786	OTHER	NY	RAILROAD MEDICARE #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	150591FF	OTHER	NY	PREFERRED CARE-ROCHESTER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000525007015	OTHER	NM	BLUE CROSS WNY #
4	5609601	OTHER	NY	INDEPENDENT HEALTH #
5	CR-128699-6W	OTHER	NY	WORKERS COMPENSATION #
6	00025194001	OTHER	NY	UNIVERA/EXCELLUS #

General Provider Information

NPI Number	:	1912906256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHOK NIGAM M.D.

Provider Business Mailing Address
First Line	:	1150 YOUNGS RD
Second Line	:	SUITE 111
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-8053
Country	:	US
Telephone Number	:	716-688-7622
Fax Number	:	716-688-7592

Provider Business Practice Location Address
First Line	:	1150 YOUNGS RD
Second Line	:	SUITE 111
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-8053
Country	:	US
Telephone Number	:	716-688-7622
Fax Number	:	716-688-7592

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	03/08/2013

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