Organization
RAJ MEDICAL DIAGNOSTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO DUNNER (ADMINISTRATION SECRETARY)
(718) 809-4921
Entity
Organization
Contact information
Practice address
887 RUTLAND RD, BROOKLYN, NY 11203
(718) 809-4921
Mailing address
887 RUTLAND RD, BROOKLYN, NY 11203-1911
(718) 809-4921
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
207R00000X
Internal Medicine Physician
0-93763
NY
207R00000X
Internal Medicine Physician
25MA09998900
NJ
207R00000X
Internal Medicine Physician
55603
CT
207R00000X
Internal Medicine Physician
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149503
STATE LICENSE
NY
Enumeration date
11/05/2015
Last updated
05/29/2018
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