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NPI Code Detail

MEDICARE: DR. ADDAGADA C RAO MD

MEDICARE:  DR. ADDAGADA C RAO  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician111527NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
290431OTHERAETNA
3D5087OTHEROXFORD

General Provider Information

NPI Number : 1164410825
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ADDAGADA C RAO MD
Provider Business Mailing Address
First Line : 145 SAINT NICHOLAS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11237-4439
Country : US
Telephone Number : 718-418-5900
Fax Number : 718-418-4368
Provider Business Practice Location Address
First Line : 145 SAINT NICHOLAS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11237-4439
Country : US
Telephone Number : 718-418-5900
Fax Number : 718-418-4368
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2005
Last Update Date : 07/08/2007

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