Healthcare Provider Details

I. General information

NPI: 1639105109
Provider Name (Legal Business Name): ASHOK BAGHEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 04/21/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 HILANDER DR
LOUDONVILLE NY
12211-2605
US

IV. Provider business mailing address

9 HILANDER DR
LOUDONVILLE NY
12211-2605
US

V. Phone/Fax

Practice location:
  • Phone: 518-301-1734
  • Fax:
Mailing address:
  • Phone: 518-301-1734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number198555
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: