Provider Demographics
NPI:1598102543
Name:DARAI, RUDRA BAHADUR
Entity Type:Individual
Prefix:MR
First Name:RUDRA
Middle Name:BAHADUR
Last Name:DARAI
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:RUDRA
Other - Middle Name:BAHADUR
Other - Last Name:DARAI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:20 DEXTER AVE
Mailing Address - Street 2:APT. # 3
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-4107
Mailing Address - Country:US
Mailing Address - Phone:617-901-8592
Mailing Address - Fax:
Practice Address - Street 1:20 DEXTER AVE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-4107
Practice Address - Country:US
Practice Address - Phone:617-901-8592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical