Provider Demographics
NPI:1396184016
Name:RAJAGOPAL, LEENA (MD)
Entity type:Individual
Prefix:DR
First Name:LEENA
Middle Name:
Last Name:RAJAGOPAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BRIDGE PLZ N STE 275
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-7586
Mailing Address - Country:US
Mailing Address - Phone:201-500-5230
Mailing Address - Fax:
Practice Address - Street 1:1610 ROUTE 88
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3018
Practice Address - Country:US
Practice Address - Phone:732-295-6543
Practice Address - Fax:732-295-6204
Is Sole Proprietor?:No
Enumeration Date:2013-06-15
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2786072084F0202X, 2084P0800X
NJ25MA098207002084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry