Provider Demographics
NPI:1578753257
Name:MALIK, RAJESH (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:
Last Name:MALIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 6TH STREET
Mailing Address - Street 2:DEPT OF SURGERY, 6TH FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215
Mailing Address - Country:US
Mailing Address - Phone:718-780-3288
Mailing Address - Fax:
Practice Address - Street 1:2450 GOODLETTE RD N
Practice Address - Street 2:SUITE 102
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4595
Practice Address - Country:US
Practice Address - Phone:239-643-8794
Practice Address - Fax:239-430-7820
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1074642086S0129X
NY2411342086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL148XPOtherBC/BS PROVIDER#
FL002468300Medicaid
FLME107464OtherSTATE LICENSE
FL148XPOtherBC/BS PROVIDER#