Provider Demographics
NPI:1780706036
Name:AJAY VERMA MEDICAL PC
Entity type:Organization
Organization Name:AJAY VERMA MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:VERMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-632-6060
Mailing Address - Street 1:421 HUGUENOT ST
Mailing Address - Street 2:SUITE 33
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-7004
Mailing Address - Country:US
Mailing Address - Phone:914-632-6060
Mailing Address - Fax:914-632-6218
Practice Address - Street 1:421 HUGUENOT ST
Practice Address - Street 2:SUITE 33
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-7004
Practice Address - Country:US
Practice Address - Phone:914-632-6060
Practice Address - Fax:914-632-6218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163990207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00926783Medicaid
NY78F461Medicare ID - Type Unspecified
NYA29695Medicare UPIN