Provider Demographics
NPI:1619204732
Name:PANDYA, ASHVINKUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHVINKUMAR
Middle Name:
Last Name:PANDYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ASHWIN
Other - Middle Name:
Other - Last Name:PANDYA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:855 BRUCE DR
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-5148
Mailing Address - Country:US
Mailing Address - Phone:516-292-9741
Mailing Address - Fax:516-292-9741
Practice Address - Street 1:855 BRUCE DR
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-5148
Practice Address - Country:US
Practice Address - Phone:516-292-9741
Practice Address - Fax:516-292-9741
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60-1145002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry