Provider Demographics
NPI:1407119613
Name:RAJA, KHALIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:KHALIKA
Middle Name:
Last Name:RAJA
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 1:1121 CONEY ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-2340
Mailing Address - Country:US
Mailing Address - Phone:718-434-7100
Mailing Address - Fax:718-434-7120
Practice Address - Street 1:1121 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-2340
Practice Address - Country:US
Practice Address - Phone:718-434-7100
Practice Address - Fax:718-434-7120
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282845208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics