Provider Demographics
NPI:1508019712
Name:RASTOGI, NEETI (MD)
Entity Type:Individual
Prefix:DR
First Name:NEETI
Middle Name:
Last Name:RASTOGI
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 1:5030 STATE RD
Mailing Address - Street 2:SUITE 2-400
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-4605
Mailing Address - Country:US
Mailing Address - Phone:610-394-1350
Mailing Address - Fax:610-394-1356
Practice Address - Street 1:5030 STATE RD
Practice Address - Street 2:SUITE 2-400
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-4605
Practice Address - Country:US
Practice Address - Phone:610-394-1350
Practice Address - Fax:610-394-1356
Is Sole Proprietor?:No
Enumeration Date:2008-10-31
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT187543390200000X
PAMD436403207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program