Provider Demographics
NPI:1205824976
Name:RAJAN-GEORGE, BIBY E (MD)
Entity Type:Individual
Prefix:DR
First Name:BIBY
Middle Name:E
Last Name:RAJAN-GEORGE
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 1:1000 E GENESEE ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1892
Mailing Address - Country:US
Mailing Address - Phone:315-471-8388
Mailing Address - Fax:315-471-8019
Practice Address - Street 1:1000 E GENESEE ST
Practice Address - Street 2:SUITE 500
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1892
Practice Address - Country:US
Practice Address - Phone:315-471-8388
Practice Address - Fax:315-471-8019
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY233105207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02619547Medicaid
NYI11269Medicare UPIN
NY02619547Medicaid