Healthcare Provider Details

I. General information

NPI: 1134194822
Provider Name (Legal Business Name): RAJESH RANGASWAMY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 MILL STREET
RENO NV
89520-1576
US

IV. Provider business mailing address

PO BOX 7055
RENO NV
89510-7055
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-8100
  • Fax: 775-982-4161
Mailing address:
  • Phone: 775-823-1999
  • Fax: 775-823-1996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberME92960
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME92960
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number13665
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: