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Individual

RAJARAM RAO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10 GRAHAM RD W, ITHACA, NY 14850-1055
(607) 257-2323
(607) 266-7341
Mailing address
10 GRAHAM RD W, ITHACA, NY 14850-1055
(607) 257-2323
(607) 266-7341

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
132414
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000910783001
HEALTHNOW
05
00467643
NY
01
07337
BLUE SHIELD/HMO/EXCELLUS
01
4215455
AETNA MANAGED CHOICE
01
6485
TOTALCARE/MANAGED MA
NY
01
V018315
TRICARE
Enumeration date
11/18/2005
Last updated
07/08/2007
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