Individual
RAJESWARA R. PATCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
172 E MAIN ST, HUNTINGTON, NY 11743-2948
(631) 385-0022
(631) 385-0896
Mailing address
172 E MAIN ST, HUNTINGTON, NY 11743-2948
(631) 385-0022
(631) 385-0896
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
147275
NY
207RI0011X
Interventional Cardiology Physician
Primary
147275
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00767395
—
NY
Enumeration date
05/31/2005
Last updated
03/19/2020
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