Provider Demographics
NPI:1588656771
Name:DUGAR, NIDHI (MD)
Entity type:Individual
Prefix:
First Name:NIDHI
Middle Name:
Last Name:DUGAR
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 1:3429 83RD ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-3054
Mailing Address - Country:US
Mailing Address - Phone:718-806-1434
Mailing Address - Fax:718-806-1435
Practice Address - Street 1:3429 83RD ST
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-3054
Practice Address - Country:US
Practice Address - Phone:718-424-4548
Practice Address - Fax:718-424-1322
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229966207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00W340S01Medicare PIN
I27558Medicare UPIN
VA177175OtherANTHEM
P00222865OtherRAILROAD MEDICARE
VA010144426Medicaid