Provider Demographics
NPI:1043603756
Name:HARYANI, AJAY
Entity type:Individual
Prefix:
First Name:AJAY
Middle Name:
Last Name:HARYANI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 SAINT JOHNS PL APT 722
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-5880
Mailing Address - Country:US
Mailing Address - Phone:332-242-6725
Mailing Address - Fax:347-286-8911
Practice Address - Street 1:632 BROADWAY PH
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-2614
Practice Address - Country:US
Practice Address - Phone:347-933-6246
Practice Address - Fax:855-318-8277
Is Sole Proprietor?:No
Enumeration Date:2015-03-05
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312958208M00000X, 207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist