Provider Demographics
NPI:1073554721
Name:JHAVERI, RITA (MD)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:JHAVERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125-07 101 AVENUE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-1411
Mailing Address - Country:US
Mailing Address - Phone:718-450-9383
Mailing Address - Fax:718-450-9384
Practice Address - Street 1:125-07 101 AVENUE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-1411
Practice Address - Country:US
Practice Address - Phone:718-450-9383
Practice Address - Fax:718-450-9384
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY192697207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF91748Medicare UPIN