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General NPI Number Information
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NPI Number | 1477732048
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Entity Type | Organization
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Legal Business Name | RAJENDRA PRADHAN, M. D. P.C.
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 247 3RD AVE SUITE 503
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City | NEW YORK
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State | NY
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Zip | 10010-7457
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Country | US
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Telephone | 212-982-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 372 CENTRAL PARK WEST 12G
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City | NEW YORK
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State | NY
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Zip | 10025-8240
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Country | US
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Telephone | 212-982-0600
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAJENDRA PRASAD PRADHAN
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Credential | MD
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Telephone | 212-982-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 114439
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License Number State | NY
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