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General NPI Number Information
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NPI Number | 1174627277
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Entity Type | Individual
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Provider Name | RAJU SARWAL MD
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Gender | Male
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Dates
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Enumeration Date | 09/11/2006
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Last Update Date | 03/14/2014
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Provider Practice Location Address
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Address Line | 601 SUFFOLK AVE
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City | BRENTWOOD
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State | NY
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Zip | 11717-4309
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Country | US
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Telephone | 631-231-4455
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Fax | 631-257-5097
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Provider Business Mailing Address
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Address Line | PO BOX 538
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City | GLENWOOD LANDING
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State | NY
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Zip | 11547-0538
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Country | US
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Telephone | 631-231-4455
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Fax | 631-257-5097
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 228351
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License Number State | NY
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