Provider Demographics
NPI:1023388428
Name:WESTCHESTER AVENUE FAMILY MEDICINE PC
Entity Type:Organization
Organization Name:WESTCHESTER AVENUE FAMILY MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AJITH
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:KARAYIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-813-9170
Mailing Address - Street 1:34 INVERNESS CT
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-5113
Mailing Address - Country:US
Mailing Address - Phone:606-813-9170
Mailing Address - Fax:718-589-7952
Practice Address - Street 1:1575 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-2912
Practice Address - Country:US
Practice Address - Phone:718-842-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-03
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03166525Medicaid