Provider Demographics
NPI:1306133293
Name:RAIBAGKAR, POOJA SANTOSH (MD)
Entity type:Individual
Prefix:DR
First Name:POOJA
Middle Name:SANTOSH
Last Name:RAIBAGKAR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:250 PLEASANT ST.
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7559
Mailing Address - Country:US
Mailing Address - Phone:603-227-7000
Mailing Address - Fax:603-228-3307
Practice Address - Street 1:246 PLEASANT ST.
Practice Address - Street 2:MEMORIAL BUILDING, WEST, GROUND FLOOR
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2548
Practice Address - Country:US
Practice Address - Phone:603-224-6691
Practice Address - Fax:603-227-7569
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2020-08-11
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Provider Licenses
StateLicense IDTaxonomies
PAMT199474207R00000X
MA2509082084N0402X
NH202882084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine