Provider Demographics
NPI:1427785443
Name:RAJPAL, KANCHAN (MD)
Entity type:Individual
Prefix:DR
First Name:KANCHAN
Middle Name:
Last Name:RAJPAL
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 1:1185 EAST BROADWAY
Mailing Address - Street 2:4C
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557
Mailing Address - Country:US
Mailing Address - Phone:516-395-6478
Mailing Address - Fax:
Practice Address - Street 1:1185 EAST BROADWAY
Practice Address - Street 2:4C
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557
Practice Address - Country:US
Practice Address - Phone:516-395-6478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151559208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice