Individual
JAYANTH RAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
150 55TH ST, RADIOLOGY DEPARTMENT, BROOKLYN, NY 11220-2559
(718) 630-7415
(718) 630-7437
Mailing address
5800 3RD AVE, MANAGED CARE DEPARTMENT, BROOKLYN, NY 11220-3702
(718) 630-7124
(718) 630-7437
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
154022
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00773322
—
NY
Enumeration date
08/28/2006
Last updated
10/02/2008
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