Individual
AJAY JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
65-11 BOOTH STREET, SUITE 1C, REGO PARK, NY 11374-4184
(718) 806-1434
(718) 806-1435
Mailing address
65-11 BOOTH STREET, SUITE 1C, REGO PARK, NY 11374-4184
(718) 806-1434
(718) 806-1435
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
238516
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00215186
RAILROAD MEDICARE
—
Enumeration date
08/16/2005
Last updated
04/08/2014
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