Provider Demographics
NPI:1225171390
Name:IMMEDIATE MEDICAL CARE
Entity Type:Organization
Organization Name:IMMEDIATE MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:AHUJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-322-3700
Mailing Address - Street 1:825 HIGH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-1904
Mailing Address - Country:US
Mailing Address - Phone:203-322-3700
Mailing Address - Fax:203-968-8870
Practice Address - Street 1:825 HIGH RIDGE RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-1904
Practice Address - Country:US
Practice Address - Phone:203-322-3700
Practice Address - Fax:203-968-8870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT110001411Medicare ID - Type UnspecifiedINTERNIST
CTB83276Medicare UPIN