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Individual

DR. RAGHAVA RAO POLAVARAPU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
26 SUNSET RD W, ALBERTSON, NY 11507-1115
(516) 621-0346
(718) 398-3104
Mailing address
26 SUNSET RD W, ALBERTSON, NY 11507-1115
(516) 621-0346
(718) 398-3104

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
126244
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00248435
NY
01
126244
LICENSE
NY
Enumeration date
11/03/2006
Last updated
07/08/2007
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