Healthcare Provider Details

I. General information

NPI: 1710407085
Provider Name (Legal Business Name): DEVI RASTOGI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PLAINSBORO RD STE 500
PLAINSBORO NJ
08536-2005
US

IV. Provider business mailing address

245 N 15TH ST # MS 495
PHILADELPHIA PA
19102-1101
US

V. Phone/Fax

Practice location:
  • Phone: 609-936-0700
  • Fax:
Mailing address:
  • Phone: 215-762-8220
  • Fax: 215-762-1470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMT214043
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: