Healthcare Provider Details

I. General information

NPI: 1902509060
Provider Name (Legal Business Name): RAHUL ANAND DO, MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HEALTHY WAY
OCEANSIDE NY
11572-1551
US

IV. Provider business mailing address

75 N COUNTRY RD
PORT JEFFERSON NY
11777-2119
US

V. Phone/Fax

Practice location:
  • Phone: 404-319-1022
  • Fax:
Mailing address:
  • Phone: 631-473-1320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number342139
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: