Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 25MA09140200 | NJ |
NPI | 1083876106 |
---|---|
Provider Name | Hariprem Rajasekhar |
First Address | Westbury, NY 11590-3171 |
Second Address | New Brunswick, NJ 08901-1928 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2008 |
Last Update Date | 17/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0302317 | (05) | NJ |