Healthcare Provider Details

I. General information

NPI: 1164620910
Provider Name (Legal Business Name): RASHIMA JAIN-AHUJA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 01/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2175 WESTCHESTER AVE
BRONX NY
10462-4734
US

IV. Provider business mailing address

2175 WESTCHESTER AVE
BRONX NY
10462-4734
US

V. Phone/Fax

Practice location:
  • Phone: 718-829-6770
  • Fax: 718-904-9145
Mailing address:
  • Phone: 718-829-6770
  • Fax: 718-904-9145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number257752
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: