Individual
RAHULDEV S. BHALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24 RESEARCH WAY, SUITE 500, SETAUKET, NY 11733
(631) 444-6720
(631) 444-6410
Mailing address
PO BOX 1559, STONY BROOK, NY 11790
(631) 444-6270
(631) 444-6410
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
245155
NY
208800000X
Urology Physician
Primary
25MA07766300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0059242
—
NJ
Enumeration date
07/04/2006
Last updated
05/01/2024
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