Provider Demographics
NPI:1366469918
Name:AJAH, OFEM (MD)
Entity Type:Individual
Prefix:DR
First Name:OFEM
Middle Name:
Last Name:AJAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 LAKE DR
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1137
Mailing Address - Country:US
Mailing Address - Phone:516-375-3716
Mailing Address - Fax:
Practice Address - Street 1:38 6TH AVE FL 4
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-4350
Practice Address - Country:US
Practice Address - Phone:718-362-3260
Practice Address - Fax:718-230-4235
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192864173000000X, 174400000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No173000000XOther Service ProvidersLegal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01472393Medicaid
NY01472393Medicaid
NY12H981Medicare ID - Type Unspecified