MEDICARE: RAJESWARA RAO PATCHA, MD,PC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician
3	207RC0001X	Clinical Cardiac Electrophysiology Physician
4	207RC0200X	Critical Care Medicine (Internal Medicine) Physician
5	207RI0011X	Interventional Cardiology Physician
6	207RS0012X	Sleep Medicine (Internal Medicine) Physician
7	207UN0901X	Nuclear Cardiology Physician
8	207RP1001X	Pulmonary Disease Physician
9	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609851807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAJESWARA RAO PATCHA, MD,PC

Provider Business Mailing Address
First Line	:	172 E MAIN ST
Second Line	:
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-2948
Country	:	US
Telephone Number	:	631-385-0022
Fax Number	:	631-385-0896

Provider Business Practice Location Address
First Line	:	172 E MAIN ST
Second Line	:
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-2948
Country	:	US
Telephone Number	:	631-385-0022
Fax Number	:	631-385-0896

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RAJESWARA RAO PATCHA
Credential	:	MD
Telephone Number	:	631-385-0022

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	03/19/2020

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