Provider Demographics
NPI:1043520398
Name:AMIN, DHRUV MAHENDRA (DO)
Entity Type:Individual
Prefix:
First Name:DHRUV
Middle Name:MAHENDRA
Last Name:AMIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 TURF LN
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2700
Mailing Address - Country:US
Mailing Address - Phone:516-395-1625
Mailing Address - Fax:
Practice Address - Street 1:21814 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-1951
Practice Address - Country:US
Practice Address - Phone:718-776-4444
Practice Address - Fax:718-776-8536
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262347-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine