Provider Demographics
NPI:1003810342
Name:ROHATGI, RAJEEV (MD)
Entity Type:Individual
Prefix:
First Name:RAJEEV
Middle Name:
Last Name:ROHATGI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-862-3295
Mailing Address - Fax:484-664-7659
Practice Address - Street 1:2001 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3915
Practice Address - Country:US
Practice Address - Phone:610-442-2082
Practice Address - Fax:610-438-2419
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA41041207RC0000X
PAMD022859-E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1715901OtherCAPITAL BLUE CROSS
PA195774OtherKEYSTONE CAPITAL
PA355306OtherCIGNA PA
PAP725707OtherOXFORD
NJ1401017OtherHIGHMARK NJ
PA195774OtherHIGHMARK PA
NJ415103Medicaid
PA1046431Medicaid
PA55595OtherAETNA US HEALTHCARE
PA883295Medicaid
PA195774FM6Medicare PIN
PA195774OtherKEYSTONE CAPITAL
PA1046431Medicaid