Provider Demographics
NPI:1346344710
Name:SAVARGAONKAR, RAJESH (MD)
Entity Type:Individual
Prefix:
First Name:RAJESH
Middle Name:
Last Name:SAVARGAONKAR
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 1:1556 STRAIGHT PATH
Mailing Address - Street 2:
Mailing Address - City:WYANDANCH
Mailing Address - State:NY
Mailing Address - Zip Code:11798
Mailing Address - Country:US
Mailing Address - Phone:631-854-1700
Mailing Address - Fax:631-854-1789
Practice Address - Street 1:1556 STRAIGHT PATH
Practice Address - Street 2:MARTIN LUTHER KING JR HEALTH CENTER
Practice Address - City:WYANDANCH
Practice Address - State:NY
Practice Address - Zip Code:11798
Practice Address - Country:US
Practice Address - Phone:631-854-1700
Practice Address - Fax:631-854-1789
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213200208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01793264Medicaid
G58351Medicare UPIN
NY01793264Medicaid