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General NPI Number Information
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NPI Number | 1992894943
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Entity Type | Individual
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Provider Name | RAJENDRA PRADHAN MD PC
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Gender | Male
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 372 CENTRAL PARK WEST APARTMENT 12G
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City | NEW YORK
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State | NY
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Zip | 10025-8209
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Country | US
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Telephone | 212-677-0396
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Fax |
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Provider Business Mailing Address
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Address Line | 372 CENTRAL PARK WEST APARTMENT 12GH
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City | NEW YORK
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State | NY
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Zip | 10025-8209
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Country | US
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Telephone | 347-875-0139
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Fax |
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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 | 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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