Provider Demographics
NPI:1225146574
Name:RAO, GOVIND C K (MD)
Entity Type:Individual
Prefix:DR
First Name:GOVIND
Middle Name:C K
Last Name:RAO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1 FRONT ST
Mailing Address - Street 2:NEENA RAO MEDICAL CENTER
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010
Mailing Address - Country:US
Mailing Address - Phone:518-843-4414
Mailing Address - Fax:518-843-4415
Practice Address - Street 1:1 FRONT
Practice Address - Street 2:NEENA RAO MEDICAL CENTER
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010
Practice Address - Country:US
Practice Address - Phone:518-843-4414
Practice Address - Fax:518-843-4415
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2008-06-20
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Provider Licenses
StateLicense IDTaxonomies
NY1115282080A0000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00515077Medicaid
NY00515077Medicaid