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General NPI Number Information
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NPI Number | 1518902691
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Entity Type | Organization
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Legal Business Name | PRABHAT AHLUWALIA
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 500 E MAIN ST
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City | LITTLE FALLS
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State | NY
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Zip | 13365-1404
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Country | US
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Telephone | 315-823-1111
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Fax | 315-823-1295
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Provider Business Mailing Address
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Address Line | 500 E MAIN ST
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City | LITTLE FALLS
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State | NY
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Zip | 13365-1404
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Country | US
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Telephone | 315-823-1111
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Fax | 315-823-1295
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Authorized Official
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Title or Position | MEDICAL PROVIDER/OWNER
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Name | PRABHAT AHLUWALIA
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Credential | MD
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Telephone | 315-823-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 154104-1
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License Number State | NY
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