MEDICARE: TEHRIMA RAI

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	390200000X	Student in an Organized Health Care Education/Training Program
2	2080P0006X	Developmental - Behavioral Pediatrics Physician	324169	NY

General Provider Information

NPI Number	:	1770109274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEHRIMA RAI

Provider Business Mailing Address
First Line	:	1565 GRAND CONCOURSE FL FLOOR
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10452-6244
Country	:	US
Telephone Number	:	812-369-5752
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 GRAND AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10453-7710
Country	:	US
Telephone Number	:	181-236-9575
Fax Number	:

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

Provider Enumeration Date	:	06/19/2020
Last Update Date	:	12/05/2025

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Directions to “ TEHRIMA RAI ” Practice Location

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