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Organization
SUJATHA MEDICAL PC
Active
Organization
SUJATHA MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUJATHA RAJAN M.D (MEDICAL DOCTOR)
(718) 264-2700
Entity
Organization
Contact information
Practice address
21414 HILLSIDE AVE, QUEENS VILLAGE, NY 11427-1808
(718) 264-2700
(718) 264-2702
Mailing address
6636 YELLOWSTONE BLVD, APT. 18F, FOREST HILLS, NY 11375-2510
(718) 264-2700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07554
MEDICARE - GHI
NY
Enumeration date
02/11/2007
Last updated
04/17/2008
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