Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 226427 | NY |
NPI | 1467491423 |
---|---|
Provider Name | Rajendra Damodar Bhayani |
First Address | Brooklyn, NY 11223-0207 |
Second Address | Brooklyn, NY 11223-1321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 04/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02608428 | (05) | NY |
H93821 | (02) | NY |