MEDICARE: NATASHA ANUSHRI ANANDARAJA 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	208000000X	Pediatrics Physician	237825	NY

General Provider Information

NPI Number	:	1952583205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATASHA ANUSHRI ANANDARAJA M.D.

Provider Business Mailing Address
First Line	:	346 BROADWAY
Second Line	:	BOX 72 RM 831 NYCDOHMH DIVISION OF DISEASE CONTROL THIR
City	:	NEW YORK
State	:	NY
Zip	:	10013-3990
Country	:	US
Telephone Number	:	212-442-8468
Fax Number	:	212-442-8452

Provider Business Practice Location Address
First Line	:	3433 JUNCTION BLVD
Second Line	:	2ND FL
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-3828
Country	:	US
Telephone Number	:	718-476-7635
Fax Number	:

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

Provider Enumeration Date	:	11/28/2007
Last Update Date	:	01/30/2012

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