Healthcare Provider Details

I. General information

NPI: 1811744543
Provider Name (Legal Business Name): RAGINI LUTHRA VAIDYA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 05/01/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE GUSTAVE LEVY PLACE BOX 1149
NEW YORK NY
10029
US

IV. Provider business mailing address

ONE GUSTAVE LEVY PLACE BOX 1149
NEW YORK NY
10029
US

V. Phone/Fax

Practice location:
  • Phone: 212-824-8069
  • Fax:
Mailing address:
  • Phone: 212-824-8069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: