Provider Demographics
NPI:1649454927
Name:BAKHRU, ASHIMA THAKUR (MD)
Entity type:Individual
Prefix:MS
First Name:ASHIMA
Middle Name:THAKUR
Last Name:BAKHRU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 EAST 32ND ST SUITE 303
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-725-5300
Mailing Address - Fax:212-725-5590
Practice Address - Street 1:145 EAST 32ND ST SUITE 303
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-725-5300
Practice Address - Fax:212-725-5590
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-22
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY249855207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03035632Medicaid
NY03035632Medicaid