Provider Demographics
NPI:1487833877
Name:ADHIA, RAJESH (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:
Last Name:ADHIA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 55TH ST
Mailing Address - Street 2:DENTAL DEPARTMENT- PEDIATRIC DENTISTRY
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2559
Mailing Address - Country:US
Mailing Address - Phone:718-630-8088
Mailing Address - Fax:
Practice Address - Street 1:150 55TH ST
Practice Address - Street 2:DENTAL DEPARTMENT- PEDIATRIC DENTISTRY
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2559
Practice Address - Country:US
Practice Address - Phone:718-630-8088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17782122300000X
MDLL6501223P0221X
NY05367711223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist