Provider Demographics
NPI:1275511065
Name:RAJAN, MANJU PAMELA (RPA-C)
Entity Type:Individual
Prefix:MISS
First Name:MANJU
Middle Name:PAMELA
Last Name:RAJAN
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Gender:F
Credentials:RPA-C
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Mailing Address - Street 1:8105 4TH AVE
Mailing Address - Street 2:APT #5F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-4452
Mailing Address - Country:US
Mailing Address - Phone:718-745-3797
Mailing Address - Fax:
Practice Address - Street 1:451 CLARKSON AVE
Practice Address - Street 2:B10 ROOM 1056
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2057
Practice Address - Country:US
Practice Address - Phone:718-245-4077
Practice Address - Fax:718-245-4078
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY008347363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant