Provider Demographics
NPI:1720022759
Name:PANDEY, AVI K (MD)
Entity type:Individual
Prefix:DR
First Name:AVI
Middle Name:K
Last Name:PANDEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AWADHESH
Other - Middle Name:K
Other - Last Name:PANDEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8045 SURREY PL
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1450
Mailing Address - Country:US
Mailing Address - Phone:718-454-1040
Mailing Address - Fax:718-454-7992
Practice Address - Street 1:6118 190TH ST
Practice Address - Street 2:SUITE 229
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-2724
Practice Address - Country:US
Practice Address - Phone:718-454-1040
Practice Address - Fax:718-454-7992
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1716051207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0801348OtherUNITED MEDICARE
113325410OtherPHCS
0006748OtherGHI
159853OtherELDERPLAN
3938872Other1199 NATIONAL BENEFIT
NY01457221Medicaid
113325410OtherMAGNACARE
171605A71OtherHEALTHFIRST MEDICAID
36E361OtherEMPIRE MEDICARE
113325410OtherCIGNA
0C8079OtherHEALTHNET
113325410OtherHORIZON
1114040OtherUNITEDHEALTHCARE
180018329OtherRAILROAD MEDICARE
113325410OtherMULTIPLAN
36E363OtherBCBS
513607OtherAETNA
DS459OtherOXFORD
171605A71OtherHEALTHFIRST MEDICAID
3938872Other1199 NATIONAL BENEFIT