Provider Demographics
NPI:1932165164
Name:DUA, ASHA (MD)
Entity Type:Individual
Prefix:MRS
First Name:ASHA
Middle Name:
Last Name:DUA
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 1:6 MEADOWBROOK LN
Mailing Address - Street 2:
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568-1112
Mailing Address - Country:US
Mailing Address - Phone:718-251-4878
Mailing Address - Fax:718-968-0573
Practice Address - Street 1:2035 RALPH AVE
Practice Address - Street 2:SUITE B10
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5300
Practice Address - Country:US
Practice Address - Phone:718-251-4878
Practice Address - Fax:718-968-0573
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215740208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY70Z64ZXRZ1Medicare PIN
NY70Z641Medicare PIN
NY5467280001Medicare NSC
NYWZXRZ1Medicare PIN