Provider Demographics
NPI:1306827092
Name:RASTOGI, NITA (MD)
Entity Type:Individual
Prefix:DR
First Name:NITA
Middle Name:
Last Name:RASTOGI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 DEVONSHIRE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109
Mailing Address - Country:US
Mailing Address - Phone:717-540-1920
Mailing Address - Fax:717-540-1927
Practice Address - Street 1:4701 DEVONSHIRE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109
Practice Address - Country:US
Practice Address - Phone:717-540-1920
Practice Address - Fax:717-540-1927
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMDL052694L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018456730002Medicaid
PA110247750OtherRAIL ROAD MEDICARE
PA538890Medicare ID - Type Unspecified
PA110247750OtherRAIL ROAD MEDICARE