Individual
DR. LEELA VADREVU RAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
222 E 41ST ST, NEW YORK, NY 10017-6739
(718) 834-1976
Mailing address
222 E 41ST ST, NEW YORK, NY 10017-6739
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
23808
WV
207W00000X
Ophthalmology Physician
Primary
343287
LA
207W00000X
Ophthalmology Physician
MD438077
PA
207W00000X
Ophthalmology Physician
NY277202
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
165836FFF
MEDICARE PROVIDER
PA
Enumeration date
06/01/2007
Last updated
08/02/2024
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