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1578940813 NPI number — AJAY JURANGAL MD

NPI Number: 1578940813
Health Care Provider/Practitioner: AJAY JURANGAL MD

Information about “1578940813” NPI (AJAY JURANGAL MD) exists in 1578940813 in HTML format HTML  |  1578940813 in plain Text format TXT  |  1578940813 in PDF (Portable Document Format) PDF  |  1578940813 in an XML format XML  formats.

NPI Number : 1578940813 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1578940813",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JURANGAL",
    "FirstName": "AJAY",
    "MiddleName": null,
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3095 HARLEM RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHEEKTOWAGA",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "14225-2500",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "716-228-8652",
    "MailingAddressFaxNumber": "716-893-3491",
    "FirstLinePracticeLocationAddress": "3095 HARLEM RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHEEKTOWAGA",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "14225-2500",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "716-228-8652",
    "PracticeLocationAddressFaxNumber": "716-893-3491",
    "EnumerationDate": "05/06/2015",
    "LastUpdateDate": "12/19/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": "12/14/2015",
    "NPIReactivationDate": "10/31/2019",
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207W00000X",
          "TaxonomyName": "Ophthalmology Physician",
          "LicenseNumber": "MD459762",
          "LicenseNumberStateCode": "PA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207W00000X",
          "TaxonomyName": "Ophthalmology Physician",
          "LicenseNumber": "300892",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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