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General NPI Number Information
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NPI Number | 1770823411
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Entity Type | Individual
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Provider Name | NEERAJ V RASTOGI MD
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Gender | Male
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Dates
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Enumeration Date | 02/16/2013
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Last Update Date | 02/03/2014
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Provider Practice Location Address
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Address Line | 1180 BEACON ST SUITE 3C
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City | BROOKLINE
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State | MA
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Zip | 02446-3885
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Country | US
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Telephone | 617-202-9222
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Fax | 617-879-0933
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Provider Business Mailing Address
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Address Line | 1180 BEACON ST SUITE 3C
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City | BROOKLINE
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State | MA
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Zip | 02446-3885
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Country | US
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Telephone | 617-202-9222
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Fax | 617-879-0933
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 242012
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License Number State | MA
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