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Individual
DR. SHANTHI RAJENDRAN
Active
Individual
DR. SHANTHI RAJENDRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
211182
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00020552502
UNIVERA
NY
01
—
000525581003
BLUECROSS BLUE SHIELD
NY
01
—
0110623
INDEPENDENT HEALTH
NY
05
—
01991253
—
NY
01
—
040426035673
FIDELIS CARE NEWYORK
NY
01
—
102966BF
PREFERRED HEALTH
NY
01
—
161601272
AETNA
NY
Enumeration date
03/02/2007
Last updated
05/20/2012
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