Healthcare Provider Details

I. General information

NPI: 1124027156
Provider Name (Legal Business Name): ANJANI K. DUBEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 12/27/2021
Certification Date: 12/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BRADHURST AVE SUITE 200N
HAWTHORNE NY
10532-2140
US

IV. Provider business mailing address

19 BRADHURST AVE STE 200N
HAWTHORNE NY
10532-2140
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-7701
  • Fax: 914-345-0653
Mailing address:
  • Phone: 914-493-7701
  • Fax: 914-345-0653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number163567
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: