Provider Demographics
NPI:1174511505
Name:RAKHIT, JAYATI (MD)
Entity Type:Individual
Prefix:MRS
First Name:JAYATI
Middle Name:
Last Name:RAKHIT
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 1:10850 PEARL RD
Mailing Address - Street 2:STE D2
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-3305
Mailing Address - Country:US
Mailing Address - Phone:440-572-5578
Mailing Address - Fax:440-572-1919
Practice Address - Street 1:2322 E 22ND ST
Practice Address - Street 2:STE 305
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-3176
Practice Address - Country:US
Practice Address - Phone:216-861-5747
Practice Address - Fax:216-861-5749
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35061435R207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0189853Medicaid
G07388Medicare UPIN
OH0189853Medicaid