MEDICARE: DR. RAO PERALA M.D.

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
1	174400000X	Specialist	113725	NY

General Provider Information

NPI Number	:	1205893252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAO PERALA M.D.

Provider Business Mailing Address
First Line	:	725 ORCHARD PARK RD
Second Line	:
City	:	WEST SENECA
State	:	NY
Zip	:	14224-3352
Country	:	US
Telephone Number	:	716-712-0441
Fax Number	:	716-712-0478

Provider Business Practice Location Address
First Line	:	725 ORCHARD PARK RD
Second Line	:
City	:	WEST SENECA
State	:	NY
Zip	:	14224-3352
Country	:	US
Telephone Number	:	716-712-0441
Fax Number	:	716-712-0478

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	07/08/2007

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