Provider Demographics
NPI:1942044235
Name:JAIN, AAYU DEERGHA
Entity type:Individual
Prefix:
First Name:AAYU
Middle Name:DEERGHA
Last Name:JAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 S HILLS RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-1526
Mailing Address - Country:US
Mailing Address - Phone:734-355-7114
Mailing Address - Fax:
Practice Address - Street 1:635 S HILLS RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-1526
Practice Address - Country:US
Practice Address - Phone:734-355-7114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program