Healthcare Provider Details

I. General information

NPI: 1598773525
Provider Name (Legal Business Name): ASHOK GHOOI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1247 SUFFOLK AVE STE 1
BRENTWOOD NY
11717-4518
US

IV. Provider business mailing address

1247 SUFFOLK AVE STE 1
BRENTWOOD NY
11717-4518
US

V. Phone/Fax

Practice location:
  • Phone: 631-273-1611
  • Fax: 631-273-1163
Mailing address:
  • Phone: 631-273-1611
  • Fax: 631-273-1163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number207810
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: