Provider Demographics
NPI:1316040686
Name:RAJENDRAN, LAKSHMANAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAKSHMANAN
Middle Name:
Last Name:RAJENDRAN
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 1:3649 HARLEM ROAD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14215-2013
Mailing Address - Country:US
Mailing Address - Phone:716-835-9192
Mailing Address - Fax:716-835-5300
Practice Address - Street 1:3649 HARLEM RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-2013
Practice Address - Country:US
Practice Address - Phone:716-835-9192
Practice Address - Fax:716-835-5300
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145271208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery