Provider Demographics
NPI:1093941817
Name:MARET, RAJANI (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJANI
Middle Name:
Last Name:MARET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3998 FAIR RIDGE DR
Mailing Address - Street 2:SUITE # 300
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2921
Mailing Address - Country:US
Mailing Address - Phone:703-293-9590
Mailing Address - Fax:703-766-9725
Practice Address - Street 1:121 DEKALB AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:718-250-8848
Practice Address - Fax:718-250-8850
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2659761207L00000X
NY1649264706390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03775188Medicaid
NYA400095502Medicare PIN