Individual
COLETTE RAJNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11050 MOUNT BELVEDERE BOULEVARD, FORT DRUM, NY 13602-5004
(315) 772-9292
Mailing address
11050 MOUNT BELVEDERE BLVD, FORT DRUM, NY 13602-5438
(315) 772-9292
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
42753
KY
207Q00000X
Family Medicine Physician
Primary
R1579
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100051470
—
KY
Enumeration date
08/09/2007
Last updated
02/19/2020
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