Provider Demographics
NPI:1083824957
Name:RAJAMOHANTY, MANJUSHA (MD)
Entity Type:Individual
Prefix:DR
First Name:MANJUSHA
Middle Name:
Last Name:RAJAMOHANTY
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 1:5171 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2254
Mailing Address - Country:US
Mailing Address - Phone:412-683-4550
Mailing Address - Fax:412-683-3233
Practice Address - Street 1:5171 LIBERTY AVENUE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2254
Practice Address - Country:US
Practice Address - Phone:412-683-4550
Practice Address - Fax:412-683-3233
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP0027349207R00000X
PAMD443611207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine