Healthcare Provider Details

I. General information

NPI: 1083876452
Provider Name (Legal Business Name): AARATHI NAGARAJA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 09/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 WASHINGTON AVE
KINGSTON NY
12401
US

IV. Provider business mailing address

1037 MAIN STREET
PEEKSKILL NY
10566-2913
US

V. Phone/Fax

Practice location:
  • Phone: 845-338-7140
  • Fax: 845-338-7141
Mailing address:
  • Phone: 845-794-2010
  • Fax: 845-794-4569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number257868
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: