Provider Demographics
NPI:1659455665
Name:DEB, AMBIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:AMBIKA
Middle Name:
Last Name:DEB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMBIKA
Other - Middle Name:
Other - Last Name:TAMANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11205 QUEENS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-8311
Mailing Address - Country:US
Mailing Address - Phone:718-732-1550
Mailing Address - Fax:718-261-2635
Practice Address - Street 1:11205 QUEENS BLVD STE A
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-8311
Practice Address - Country:US
Practice Address - Phone:718-732-1550
Practice Address - Fax:718-261-2635
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184413207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02179477Medicaid
NY02179477Medicaid
H53312Medicare UPIN