Individual
AJAY V. BERDIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
640 BELLE TERRE ROAD, BUILDING H, PORT JEFFERSON, NY 11777-0001
(631) 474-1112
(631) 474-1112
Mailing address
200 BELLE TERRE RD, PORT JEFFERSON, NY 11777-1928
(631) 474-6300
(631) 474-6161
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
196859
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01524845
—
NY
01
—
087312
BLUE CROSS BLUE SHIELD
NY
01
—
130019918
RAIL ROAD MEDICARE
NY
01
—
196859
HIP HEALTH PLANS
NY
01
—
2190491
AETNA HEALTH PLANS
NY
01
—
3099464
GHI HEALTH INSURANCE
NY
01
—
48613
VYTRA HEALTH PLANS
NY
01
—
810620
FIRST HEALTH INSURANCE
NY
01
—
P560221
OXFORD HEALTH PLANS
NY
Enumeration date
06/15/2005
Last updated
06/06/2014
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