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General NPI Number Information
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NPI Number | 1528232873
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Entity Type | Organization
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Legal Business Name | RAKESH K DUA PHYSICIAN, PC
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 2035 RALPH AVE SUITE B8
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City | BROOKLYN
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State | NY
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Zip | 11234-5300
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Country | US
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Telephone | 718-968-2534
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Fax | 718-968-0573
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Provider Business Mailing Address
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Address Line | 6 MEADOWBROOK LN
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City | OLD WESTBURY
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State | NY
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Zip | 11568-1112
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Country | US
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Telephone | 718-968-2534
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Fax | 718-968-0573
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. BARBARA MARTES
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Credential |
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Telephone | 718-968-2534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 208733
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License Number State | NY
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