Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 203816 | NY |
NPI | 1477626711 |
---|---|
Provider Name | Sujatha Rajan |
First Address | New Hyde Park, NY 11040 |
Second Address | New Hyde Park, NY 11040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/07/2007 |