Provider Demographics
NPI:1699271932
Name:BARSOOM, RANDA RAAFAT (MD)
Entity type:Individual
Prefix:DR
First Name:RANDA
Middle Name:RAAFAT
Last Name:BARSOOM
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 1:1201 NOTT ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-2589
Mailing Address - Country:US
Mailing Address - Phone:518-370-1814
Mailing Address - Fax:
Practice Address - Street 1:1201 NOTT ST STE 202
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2589
Practice Address - Country:US
Practice Address - Phone:518-370-1814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY32101208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program