Provider Demographics
NPI:1851898951
Name:HIRA, AJAY PAUL SINGH (MD)
Entity Type:Individual
Prefix:
First Name:AJAY
Middle Name:PAUL SINGH
Last Name:HIRA
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 1:2690 5TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-6584
Mailing Address - Country:US
Mailing Address - Phone:510-439-9447
Mailing Address - Fax:
Practice Address - Street 1:121 DEKALB AVENUE
Practice Address - Street 2:HOUSE STAFF ADMINISTRATION
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5493
Practice Address - Country:US
Practice Address - Phone:718-250-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA173891207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program