Healthcare Provider Details

I. General information

NPI: 1023578481
Provider Name (Legal Business Name): AUSHIM KOKROO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 WHITE PLAINS RD
SCARSDALE NY
10583-5002
US

IV. Provider business mailing address

4215 CRESCENT ST APT 8K
LONG ISLAND CITY NY
11101-4444
US

V. Phone/Fax

Practice location:
  • Phone: 914-849-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number318782
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number318782
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: