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NPI Code Detail

MEDICARE: RAJATH RAO MD

MEDICARE:   RAJATH  RAO  MD
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
12085R0202XDiagnostic Radiology Physician25MA12877000NJ
22085R0202XDiagnostic Radiology Physician036172018IL
32085R0202XDiagnostic Radiology Physician340350NY

General Provider Information

NPI Number : 1164041083
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAJATH RAO MD
Provider Business Mailing Address
First Line : 54 WATKINS AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10312-1523
Country : US
Telephone Number : 201-668-1540
Fax Number :
Provider Business Practice Location Address
First Line : 475 SEAVIEW AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10305-3436
Country : US
Telephone Number : 718-226-8855
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2020
Last Update Date : 02/05/2026

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