Individual
BHAVANA BHAGYA RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
17 E 102ND ST, NEW YORK, NY 10029-5204
(212) 241-8100
(646) 537-8921
Mailing address
150 E 42ND ST FL 9, NEW YORK, NY 10017-5699
(646) 605-8186
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD467502
PA
207RG0100X
Gastroenterology Physician
Primary
304118
NY
207RG0100X
Gastroenterology Physician
MD467502
PA
Other
Enumeration date
06/24/2013
Last updated
07/08/2020
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