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NPI Code Detail

MEDICARE: SANJAY RASTOGI M.D.

MEDICARE: SANJAY RASTOGI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD058970LPA

General Provider Information

NPI Number : 1063414415
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANJAY RASTOGI M.D.
Provider Business Mailing Address
First Line : 193 OLD SWEDE RD
Second Line :
City : DOUGLASSVILLE
State : PA
Zip : 19518-1522
Country : US
Telephone Number : 610-385-3010
Fax Number : 610-385-3076
Provider Business Practice Location Address
First Line : 193 OLD SWEDE RD
Second Line :
City : DOUGLASSVILLE
State : PA
Zip : 19518-1522
Country : US
Telephone Number : 610-385-3010
Fax Number : 610-385-3076
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 07/09/2007

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