Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | A-1528-09 | NM |
NPI | 1316996283 |
---|---|
Provider Name | Sunita M Rajput |
First Address | Albuquerque, NM 87106-4375 |
Second Address | Albuquerque, NM 87106-2719 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 19/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000526113006 | HMO BCBSWNY (01) | NY |
G76797 | (02) |