MEDICARE: DR. THAKOR C RANA 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	115361	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1609808476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THAKOR C RANA M.D

Provider Business Mailing Address
First Line	:	3184 GRAND CONCOURSE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10458-1007
Country	:	US
Telephone Number	:	718-584-0555
Fax Number	:	718-584-0793

Provider Business Practice Location Address
First Line	:	3184 GRAND CONCOURSE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10458-1007
Country	:	US
Telephone Number	:	718-584-0555
Fax Number	:	718-584-0793

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	03/13/2012

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