Provider Demographics
NPI:1194986117
Name:RASTOGI, PRAMIT
Entity type:Individual
Prefix:
First Name:PRAMIT
Middle Name:
Last Name:RASTOGI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 W MOUNT ROYAL AVE
Mailing Address - Street 2:UNIT # 440
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-4132
Mailing Address - Country:US
Mailing Address - Phone:202-361-9116
Mailing Address - Fax:
Practice Address - Street 1:BLOOMBERG CHILDRENS CENTER 1800 ORLEANS ST
Practice Address - Street 2:ROOM 12347
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0001
Practice Address - Country:US
Practice Address - Phone:410-955-7858
Practice Address - Fax:410-955-8691
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program