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Individual

DR. MADHU RAJANNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
327 BEACH 19TH STREET, PSYCHIATRY DEPARTMENT, FAR ROCKAWAY, NY 11691-4423
(718) 869-7248
Mailing address
327 BEACH 19TH ST, PROVIDER ENROLLMENT, FAR ROCKAWAY, NY 11691-4423

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
238321
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02802326
NY
Enumeration date
10/02/2006
Last updated
10/17/2019
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