MEDICARE: SAREH RAJAEE SAREH RAJAEE

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	2086S0129X	Vascular Surgery Physician	289856	NY

General Provider Information

NPI Number	:	1336430958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAREH RAJAEE SAREH RAJAEE

Provider Business Mailing Address
First Line	:	960 50TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-3399
Country	:	US
Telephone Number	:	718-438-3800
Fax Number	:	718-438-3131

Provider Business Practice Location Address
First Line	:	960 50TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-3399
Country	:	US
Telephone Number	:	718-438-3800
Fax Number	:	718-438-3131

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

Provider Enumeration Date	:	04/30/2011
Last Update Date	:	01/02/2018

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