Provider Demographics
NPI:1255675708
Name:DOSHI, ANITA (MD)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:DOSHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:GULLEDGE
Other - Last Name:DOSHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12108 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-1812
Mailing Address - Country:US
Mailing Address - Phone:718-924-2240
Mailing Address - Fax:718-477-5300
Practice Address - Street 1:12108 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1812
Practice Address - Country:US
Practice Address - Phone:718-924-2240
Practice Address - Fax:718-477-5300
Is Sole Proprietor?:No
Enumeration Date:2012-11-22
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60 265891208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3579760Medicaid