Provider Demographics
NPI:1225113681
Name:BHATNAGAR, RAJESH M (MD)
Entity Type:Individual
Prefix:
First Name:RAJESH
Middle Name:M
Last Name:BHATNAGAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-6910
Mailing Address - Country:US
Mailing Address - Phone:718-960-1500
Mailing Address - Fax:718-960-1501
Practice Address - Street 1:MMG - GRAND CONCOURSE
Practice Address - Street 2:2532 GRAND CONCOURSE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458
Practice Address - Country:US
Practice Address - Phone:718-960-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113312208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics