Healthcare Provider Details

I. General information

NPI: 1861014177
Provider Name (Legal Business Name): RAJAPILLAI LABAN ISAAC PILLAI MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2020
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1741 ASHLAND AVE
BALTIMORE MD
21205-1531
US

IV. Provider business mailing address

1741 ASHLAND AVE
BALTIMORE MD
21205-1531
US

V. Phone/Fax

Practice location:
  • Phone: 443-923-7600
  • Fax:
Mailing address:
  • Phone: 443-923-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0005X
TaxonomyNeurodevelopmental Disabilities Physician
License NumberD0105089
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License Number1016515
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: