Provider Demographics
NPI:1841275617
Name:NAVLANI, ASHOK D (MD,)
Entity type:Individual
Prefix:
First Name:ASHOK
Middle Name:D
Last Name:NAVLANI
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 1:16 DEAMER CT
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-3427
Mailing Address - Country:US
Mailing Address - Phone:631-760-2227
Mailing Address - Fax:631-421-2683
Practice Address - Street 1:300 RAWLS DR
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-2849
Practice Address - Country:US
Practice Address - Phone:601-249-2676
Practice Address - Fax:601-249-2673
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS17729174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00125225Medicaid