Basic Information
Provider Information
NPI: 1063075133
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ASHOKA
FirstName: ANKITA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ANKITA
OtherFirstName: ASHOKA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 2
Mailing Information
Address1: 1501 N. CAMPBELL AVE ROOM 6336
Address2: P O BOX 245040
City: TUCSON
State: AZ
PostalCode: 857245040
CountryCode: US
TelephoneNumber: 5206268818
FaxNumber:  
Practice Location
Address1: 1501 N CAMPBELL AVE RM 6336
Address2:  
City: TUCSON
State: AZ
PostalCode: 857240001
CountryCode: US
TelephoneNumber: 5206262761
FaxNumber: 5206266020
Other Information
ProviderEnumerationDate: 04/15/2019
LastUpdateDate: 06/06/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/06/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XR77236AZY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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