Provider Demographics
NPI:1235308784
Name:KIRI, AJAY NARENDRA (MD)
Entity Type:Individual
Prefix:
First Name:AJAY
Middle Name:NARENDRA
Last Name:KIRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3505 E TREMONT AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-2026
Mailing Address - Country:US
Mailing Address - Phone:917-383-7517
Mailing Address - Fax:888-761-8317
Practice Address - Street 1:3505 E TREMONT AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2026
Practice Address - Country:US
Practice Address - Phone:917-383-7517
Practice Address - Fax:888-761-8317
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYA259884-1171100000X
NY259884207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No171100000XOther Service ProvidersAcupuncturist
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine