MEDICARE: JITENDRA N TOLIA MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	174996	NY
2	207RP1001X	Pulmonary Disease Physician	174996	NY
3	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	174996	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700956208
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JITENDRA N TOLIA MD PC

Provider Business Mailing Address
First Line	:	31 47 77TH STREET
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11370-1824
Country	:	US
Telephone Number	:	718-429-4444
Fax Number	:	718-639-5353

Provider Business Practice Location Address
First Line	:	31 47 77TH STREET
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11370-1824
Country	:	US
Telephone Number	:	718-429-4444
Fax Number	:	718-639-5353

Authorized Official
Title or Position	:	PRESIDENT OWNER
Name	:	JITENDRA N TOLIA
Credential	:	MD
Telephone Number	:	718-429-4444

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	09/11/2025

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