Provider Demographics
NPI:1063294858
Name:SASIKUMAR, RAJESH (MD)
Entity type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:
Last Name:SASIKUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UPMC MERCY PAVILION
Mailing Address - Street 2:1622 LOCUST STREET
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219
Mailing Address - Country:US
Mailing Address - Phone:055-956-8621
Mailing Address - Fax:
Practice Address - Street 1:UPMC MERCY PAVILION
Practice Address - Street 2:1622 LOCUST STREET
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-1521
Practice Address - Country:US
Practice Address - Phone:412-418-5858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PALT000983207WX0009X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist