Provider Demographics
NPI:1366485294
Name:AHUJA, SANGEETA D (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SANGEETA
Middle Name:D
Last Name:AHUJA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CAPRI CT
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6400
Mailing Address - Country:US
Mailing Address - Phone:631-940-3033
Mailing Address - Fax:
Practice Address - Street 1:11 CAPRI CT
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-6400
Practice Address - Country:US
Practice Address - Phone:631-940-3033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2011-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012117-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQU6171Medicare PIN