Healthcare Provider Details

I. General information

NPI: 1275859183
Provider Name (Legal Business Name): ANKIT NAYYAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2010
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10590 WILSHIRE BLVD APT 1003
LOS ANGELES CA
90024-7311
US

IV. Provider business mailing address

10275 LITTLE PATUXENT PKWY STE 300
COLUMBIA MD
21044-3445
US

V. Phone/Fax

Practice location:
  • Phone: 888-464-2466
  • Fax:
Mailing address:
  • Phone: 888-464-2466
  • Fax: 410-740-1518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number281043
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number281043
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: