Provider Demographics
NPI:1194573477
Name:JHA, ABHUSHAN
Entity type:Individual
Prefix:
First Name:ABHUSHAN
Middle Name:
Last Name:JHA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1667 CORNELIA ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-4711
Mailing Address - Country:US
Mailing Address - Phone:347-792-6044
Mailing Address - Fax:
Practice Address - Street 1:1667 CORNELIA ST APT 2R
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-4711
Practice Address - Country:US
Practice Address - Phone:347-792-6044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program