Provider Demographics
NPI:1104236157
Name:RATHI, POOJA
Entity type:Individual
Prefix:MS
First Name:POOJA
Middle Name:
Last Name:RATHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STONY BROOK LONG ISLAND CHILDRENS HOPSITAL
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS, HSC T-11, ROOM 040
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8111
Mailing Address - Country:US
Mailing Address - Phone:631-444-2020
Mailing Address - Fax:631-444-2894
Practice Address - Street 1:STONY BROOK LONG ISLAND CHILDRENS HOPSITAL
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS, HSC T-11, ROOM 040
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8111
Practice Address - Country:US
Practice Address - Phone:631-444-2020
Practice Address - Fax:631-444-2894
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program