Provider Demographics
NPI:1861595308
Name:RAJPUT, ASHOK K (MD)
Entity type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:K
Last Name:RAJPUT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:21 PHAETONS DR
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2028
Mailing Address - Country:US
Mailing Address - Phone:631-421-4264
Mailing Address - Fax:631-421-7063
Practice Address - Street 1:8404 PENELOPE AVE
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2433
Practice Address - Country:US
Practice Address - Phone:718-894-6963
Practice Address - Fax:718-523-2728
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1632322084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00929020Medicaid
NYE37972Medicare UPIN
NY33050Medicare ID - Type Unspecified