Individual
DR. RAJBALA THAKUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
601 ELMWOOD AVE, BOX 604, ROCHESTER, NY 14642-0001
(585) 275-5982
(585) 756-0169
Mailing address
601 ELMWOOD AVE, BOX 604, ROCHESTER, NY 14642-0001
(585) 275-5982
(585) 756-0169
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
199637
NY
207LH0002X
Hospice and Palliative Medicine (Anesthesiology) Physician
199637
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
199637
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00040826601
UNIVERA
NY
01
—
00040826602
UNIVERA PTC
NY
01
—
000912439001
BS WNY/HEALTHNOW
NY
05
—
01576021
—
NY
01
—
050059021
RAILROAD MEDICARE
NY
01
—
058157
MVP PROVIDER
NY
01
—
199637-0
WORKER'S COMP
NY
01
—
2222
BLUE SHIELD GROUP
NY
01
—
5398992
GHI
NY
01
—
7152065
AETNA
NY
01
—
G0189393590
BLUE CHOICE PTC GROUP
NY
01
—
MDA531
PREFERRED CARE
NY
01
—
MDG079
PREFERRED CARE PTC
NY
01
—
P010199637
BLUE CHOICE PTC
NY
Enumeration date
07/14/2006
Last updated
07/06/2023
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