Ajay V. Berdia, M.D.
Specialist in Port Jefferson, NY. Individual provider (NPI-1).
NPI number1801891908
StatusActive
Last updated in NPPESJun 6, 2014
Details
- NPI
- 1801891908
- Entity type
- Individual (NPI-1)
- Name
- Ajay V. Berdia
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 15, 2005
- Last updated
- Jun 6, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 196859 | NY | Yes |
Practice location
640 Belle Terre Road, Building HPort Jefferson, NY 11777-0001
Phone 631-474-1112 · Fax 631-474-1112
Mailing address
200 Belle Terre RdPort Jefferson, NY 11777-1928
Phone 631-474-6300 · Fax 631-474-6161
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