Provider Demographics
NPI:1376987123
Name:AMARNANI, AJAY NARAYAN (MD)
Entity Type:Individual
Prefix:
First Name:AJAY
Middle Name:NARAYAN
Last Name:AMARNANI
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 1:8207 MAIN ST
Mailing Address - Street 2:SUITE 14
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6060
Mailing Address - Country:US
Mailing Address - Phone:716-204-8730
Mailing Address - Fax:716-276-9249
Practice Address - Street 1:911 LAMAR AVE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-4681
Practice Address - Country:US
Practice Address - Phone:903-785-7546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
TXS6349207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program