Healthcare Provider Details

I. General information

NPI: 1164466728
Provider Name (Legal Business Name): RAJVEER PUROHIT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 04/21/2020
Certification Date: 04/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 E 77TH ST
NEW YORK NY
10021-2318
US

IV. Provider business mailing address

445 E 77TH ST
NEW YORK NY
10021-2318
US

V. Phone/Fax

Practice location:
  • Phone: 212-772-3900
  • Fax: 212-772-1919
Mailing address:
  • Phone: 212-772-3900
  • Fax: 212-772-1919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number231085
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number231085
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: