Provider Demographics
NPI:1578940813
Name:JURANGAL, AJAY (MD)
Entity Type:Individual
Prefix:MR
First Name:AJAY
Middle Name:
Last Name:JURANGAL
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:CHENANGO EYE ASSOCIATES PHYSICIANS & SURGEONS, P.C.
Mailing Address - Street 2:194 GRANDVIEW LANE
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-3331
Mailing Address - Country:US
Mailing Address - Phone:607-334-3225
Mailing Address - Fax:607-334-5946
Practice Address - Street 1:CHENANGO EYE ASSOCIATES PHYSICIANS & SURGEONS, P.C.
Practice Address - Street 2:194 GRANDVIEW LANE
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-3331
Practice Address - Country:US
Practice Address - Phone:607-334-3225
Practice Address - Fax:607-334-5946
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2019-12-27
Deactivation Date:2015-12-14
Deactivation Code:
Reactivation Date:2019-10-31
Provider Licenses
StateLicense IDTaxonomies
NY300892207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology