Provider Demographics
NPI:1003951377
Name:LODHA, NARENDRA MAL (MD)
Entity Type:Individual
Prefix:DR
First Name:NARENDRA
Middle Name:MAL
Last Name:LODHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 UNION AVE
Mailing Address - Street 2:# STE A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-7467
Mailing Address - Country:US
Mailing Address - Phone:718-387-3237
Mailing Address - Fax:718-963-0787
Practice Address - Street 1:202 UNION AVE
Practice Address - Street 2:# A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-7467
Practice Address - Country:US
Practice Address - Phone:718-387-3237
Practice Address - Fax:718-963-0787
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128662207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00237852Medicaid
NY306571Medicare ID - Type Unspecified
B12635Medicare UPIN