Provider Demographics
NPI:1417691312
Name:RAJAMAHANTY, APARAJITA (DPM)
Entity Type:Individual
Prefix:
First Name:APARAJITA
Middle Name:
Last Name:RAJAMAHANTY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 STONE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MAKANDA
Mailing Address - State:IL
Mailing Address - Zip Code:62958-2754
Mailing Address - Country:US
Mailing Address - Phone:618-303-7709
Mailing Address - Fax:
Practice Address - Street 1:1440 STONE CREEK DR
Practice Address - Street 2:
Practice Address - City:MAKANDA
Practice Address - State:IL
Practice Address - Zip Code:62958-2754
Practice Address - Country:US
Practice Address - Phone:618-303-7709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program