Provider Demographics
NPI:1326636119
Name:MAGNOLIA RHEUMATOLOGY, P.C.
Entity Type:Organization
Organization Name:MAGNOLIA RHEUMATOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUCHI
Authorized Official - Middle Name:
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-639-2700
Mailing Address - Street 1:2 OVERHILL ROAD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5336
Mailing Address - Country:US
Mailing Address - Phone:914-639-2700
Mailing Address - Fax:833-992-2090
Practice Address - Street 1:2 OVERHILL ROAD
Practice Address - Street 2:SUITE 220
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5336
Practice Address - Country:US
Practice Address - Phone:914-639-2700
Practice Address - Fax:833-992-2090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-06
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty