Provider Demographics
NPI:1083933550
Name:RAJWADKAR, LEENA MAYURESH (MD)
Entity Type:Individual
Prefix:
First Name:LEENA
Middle Name:MAYURESH
Last Name:RAJWADKAR
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 1:31 ROCHE BROTHERS WAY STE 210
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-1038
Mailing Address - Country:US
Mailing Address - Phone:508-894-8760
Mailing Address - Fax:508-894-0412
Practice Address - Street 1:31 ROCHE BROS WAY
Practice Address - Street 2:
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-1032
Practice Address - Country:US
Practice Address - Phone:508-894-8760
Practice Address - Fax:508-894-0412
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA125201208000000X
TXBP1-0037768390200000X
MA255101208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program