Healthcare Provider Details

I. General information

NPI: 1760312367
Provider Name (Legal Business Name): MADHUMITA RASIKA RAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 1ST AVE
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

31 WOODSIDE DR
TOLLAND CT
06084-2860
US

V. Phone/Fax

Practice location:
  • Phone: 484-716-2920
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835S0206X
TaxonomySolid Organ Transplant Pharmacist
License Number071571-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: