Provider Demographics
NPI:1205003290
Name:RAJAN, SARA JOHN (RPA-C)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:JOHN
Last Name:RAJAN
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 4TH PL S
Mailing Address - Street 2:GARDENCITY,
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5208
Mailing Address - Country:US
Mailing Address - Phone:516-993-6640
Mailing Address - Fax:
Practice Address - Street 1:670 4TH PL S
Practice Address - Street 2:GARDENCITY,
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5208
Practice Address - Country:US
Practice Address - Phone:516-993-6640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012481-1146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant