Provider Demographics
NPI:1790002020
Name:DESHMUKH, AJIT J (MD)
Entity type:Individual
Prefix:
First Name:AJIT
Middle Name:J
Last Name:DESHMUKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:22414 MERRICK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-2023
Mailing Address - Country:US
Mailing Address - Phone:718-949-6433
Mailing Address - Fax:718-949-0331
Practice Address - Street 1:22414 MERRICK BLVD
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-2023
Practice Address - Country:US
Practice Address - Phone:718-949-6433
Practice Address - Fax:718-949-0331
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2021-03-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY272719207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery