Provider Demographics
NPI:1376568279
Name:KATARA, RAJ L (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJ
Middle Name:L
Last Name:KATARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3 PARKINSON RD
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-8087
Mailing Address - Country:US
Mailing Address - Phone:570-424-1102
Mailing Address - Fax:570-517-5853
Practice Address - Street 1:3 PARKINSON RD
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-8087
Practice Address - Country:US
Practice Address - Phone:570-424-1102
Practice Address - Fax:570-517-5853
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD071383L2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC21061OtherGROUP RAILROAD MEDICARE
PAP00041001OtherRAILROAD MEDICARE NUMBER
PA001955361 0001Medicaid
PAP00041001OtherRAILROAD MEDICARE NUMBER
PAC21061OtherGROUP RAILROAD MEDICARE
PA069855GQ9Medicare PIN