MEDICARE: MRS. ASHA DUA MD

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	208100000X	Physical Medicine & Rehabilitation Physician	215740	NY

General Provider Information

NPI Number	:	1932165164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHA DUA MD

Provider Business Mailing Address
First Line	:	6 MEADOWBROOK LN
Second Line	:
City	:	OLD WESTBURY
State	:	NY
Zip	:	11568-1112
Country	:	US
Telephone Number	:	718-251-4878
Fax Number	:	718-968-0573

Provider Business Practice Location Address
First Line	:	2035 RALPH AVE
Second Line	:	SUITE B10
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5300
Country	:	US
Telephone Number	:	718-251-4878
Fax Number	:	718-968-0573

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	04/01/2008

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