Provider Demographics
NPI:1922461730
Name:ASRANI, ROSHAN C (MD)
Entity Type:Individual
Prefix:
First Name:ROSHAN
Middle Name:C
Last Name:ASRANI
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 1:17 E 102ND ST FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-5204
Mailing Address - Country:US
Mailing Address - Phone:212-659-5528
Mailing Address - Fax:212-987-3326
Practice Address - Street 1:1470 MADISON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6542
Practice Address - Country:US
Practice Address - Phone:212-241-6756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2022-09-30
Deactivation Date:2022-06-21
Deactivation Code:
Reactivation Date:2022-08-03
Provider Licenses
StateLicense IDTaxonomies
NY404504207R00000X
NY301472207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine