Provider Demographics
NPI:1548237167
Name:AHUJA, KISHORE K (MD)
Entity Type:Individual
Prefix:DR
First Name:KISHORE
Middle Name:K
Last Name:AHUJA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3071 PERRY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-4111
Mailing Address - Country:US
Mailing Address - Phone:718-231-6700
Mailing Address - Fax:715-515-5454
Practice Address - Street 1:3071 PERRY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-4111
Practice Address - Country:US
Practice Address - Phone:718-231-6700
Practice Address - Fax:715-515-5454
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY142213207KA0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00142213OtherMETRO PLUS
NY0881608/1039OtherCIGNA
NY119129OtherWELLCARE
NY0000000191290009OtherGHI HMO
NY040426024474OtherFIDELIS
NY040426024475OtherFIDELIS
NY087786OtherAETNA US HEALTHCARE
NY5N8331OtherBLUE CROSS BLUE SHEILD
NY79580OtherAETNA US HEALTHCARE
NYOK8753OtherHEALTH NET
NYP408653OtherOXFORD HEALTH PLAN
NYBX0000301OtherAMERICHOICE
NY00609018Medicaid
NY142213A14OtherHEALTH FIRST
NY2099748OtherGHI
NY142213OtherHIP
NY5N8331OtherBLUE CROSS BLUE SHEILD
NYB78895Medicare UPIN