Provider Demographics
NPI:1124316369
Name:RAJNARINE, TARIQ ZACHARY (MD)
Entity type:Individual
Prefix:DR
First Name:TARIQ
Middle Name:ZACHARY
Last Name:RAJNARINE
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 1:60 E TOWNSHIP LINE RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19117-2220
Mailing Address - Country:US
Mailing Address - Phone:215-663-6677
Mailing Address - Fax:215-663-6265
Practice Address - Street 1:10 HANOVER SQ
Practice Address - Street 2:APT 14F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005-3510
Practice Address - Country:US
Practice Address - Phone:202-361-0818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMD459278208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program