Provider Demographics
NPI:1528099959
Name:DEBROY, MEELIE ASHIMA (MD)
Entity type:Individual
Prefix:
First Name:MEELIE
Middle Name:ASHIMA
Last Name:DEBROY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WOODS RD
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1530
Mailing Address - Country:US
Mailing Address - Phone:914-493-5688
Mailing Address - Fax:914-493-2424
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-493-5688
Practice Address - Fax:914-493-8637
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07828700204F00000X
OH35.132238208600000X
NY326988208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0059251Medicaid
NJ0059251Medicaid
NJ086841Medicare ID - Type Unspecified