Healthcare Provider Details

I. General information

NPI: 1598959595
Provider Name (Legal Business Name): VEERESH BAJAJ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2007
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3029 38TH ST
ASTORIA NY
11103-3875
US

IV. Provider business mailing address

PO BOX 75
JERICHO NY
11753
US

V. Phone/Fax

Practice location:
  • Phone: 229-873-3296
  • Fax: 229-873-3297
Mailing address:
  • Phone: 718-806-1434
  • Fax: 718-806-1435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number289822
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number289822
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: