Healthcare Provider Details

I. General information

NPI: 1619094802
Provider Name (Legal Business Name): VARINDER S RATHORE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 OLD MAIN ST STE 208
FISHKILL NY
12524-1883
US

IV. Provider business mailing address

70 MELANIE LN
HOPEWELL JUNCTION NY
12533-5566
US

V. Phone/Fax

Practice location:
  • Phone: 845-231-0321
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number234543
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number234543
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: