Provider Demographics
NPI:1356509491
Name:RAGHUPATHY, RADHA V (MD)
Entity Type:Individual
Prefix:
First Name:RADHA
Middle Name:V
Last Name:RAGHUPATHY
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 1:804 ROCKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-1413
Mailing Address - Country:US
Mailing Address - Phone:781-254-4499
Mailing Address - Fax:
Practice Address - Street 1:804 ROCKLAND AVE
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-1413
Practice Address - Country:US
Practice Address - Phone:781-254-4499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP57738207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology