Healthcare Provider Details

I. General information

NPI: 1417966185
Provider Name (Legal Business Name): NEERA AHUJA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 02/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 MARCY AVE
BROOKLYN NY
11216-1524
US

IV. Provider business mailing address

34 DANVILLE DR
GREENLAWN NY
11740-2813
US

V. Phone/Fax

Practice location:
  • Phone: 718-230-0350
  • Fax:
Mailing address:
  • Phone: 631-754-4930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number148029
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: