Provider Demographics
NPI:1386605517
Name:BHATNAGAR, RAJESH (MD)
Entity type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:
Last Name:BHATNAGAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:26 W WOODS RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11020-1220
Mailing Address - Country:US
Mailing Address - Phone:718-239-6987
Mailing Address - Fax:718-239-1601
Practice Address - Street 1:1250 WATERS PL
Practice Address - Street 2:SUITE 1203
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2720
Practice Address - Country:US
Practice Address - Phone:718-239-6987
Practice Address - Fax:718-239-1601
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2110662084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01947144Medicaid
NY01947144Medicaid
NY03047Medicare PIN