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General NPI Number Information
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NPI Number | 1669664686
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Entity Type | Organization
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Legal Business Name | ASHA DUA PHYSICIAN PC
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 04/19/2010
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Provider Practice Location Address
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Address Line | 2035 RALPH AVE STE B10
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City | BROOKLYN
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State | NY
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Zip | 11234-5300
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Country | US
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Telephone | 718-251-4878
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Fax | 718-968-0573
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Provider Business Mailing Address
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Address Line | 6 MEADOWBROOK LN
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City | OLD WESTBURY
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State | NY
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Zip | 11568-1112
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Country | US
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Telephone | 718-251-4878
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Fax | 718-968-0573
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Authorized Official
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Title or Position | PHYSICAL MEDICINE AND REHAB
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Name | DR. ASHA DUA
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Credential | PC
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Telephone | 718-251-4878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 215740
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 215740
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License Number State | NY
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