Provider Demographics
NPI:1306821244
Name:FLORES, RAJA M (MD)
Entity Type:Individual
Prefix:
First Name:RAJA
Middle Name:M
Last Name:FLORES
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Gender:M
Credentials:MD
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Mailing Address - Street 1:150 EAST 42ND STREET
Mailing Address - Street 2:10TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017
Mailing Address - Country:US
Mailing Address - Phone:646-605-8119
Mailing Address - Fax:646-605-3031
Practice Address - Street 1:1190 FIFTH AVENUE
Practice Address - Street 2:MOUNT SINAI MEDICAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6503
Practice Address - Country:US
Practice Address - Phone:212-241-9466
Practice Address - Fax:212-659-1521
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2016-06-09
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Provider Licenses
StateLicense IDTaxonomies
NY219223208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
001G31Medicare ID - Type Unspecified
H31901Medicare UPIN