Organization
RAJESH MARIWALLA, MD PC
Active
Organization
RAJESH MARIWALLA, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJESH MARIWALLA MD (MD)
(631) 422-9600
Entity
Organization
Contact information
Practice address
1175 MONTAUK HWY, SUITE 4, WEST ISLIP, NY 11795-4939
(631) 422-9600
(631) 422-9697
Mailing address
1175 MONTAUK HWY, SUITE 4, WEST ISLIP, NY 11795-4939
(631) 422-9600
(631) 422-9697
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
153786
NY
208000000X
Pediatrics Physician
209194
NY
208000000X
Pediatrics Physician
217202
NY
363A00000X
Physician Assistant
008888
NY
Other
Enumeration date
02/03/2015
Last updated
02/18/2015
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