Provider Demographics
NPI:1518933795
Name:RAO, SABITHA S (MD)
Entity Type:Individual
Prefix:
First Name:SABITHA
Middle Name:S
Last Name:RAO
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 1:503 5TH AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4811
Mailing Address - Country:US
Mailing Address - Phone:718-768-7284
Mailing Address - Fax:718-768-1334
Practice Address - Street 1:503 5TH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4811
Practice Address - Country:US
Practice Address - Phone:718-768-7284
Practice Address - Fax:718-768-1334
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY139133208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
I02640Medicare UPIN