Provider Demographics
NPI:1598984601
Name:KARUVELANKULAM SUBBIAH, RAJAN S (MD)
Entity Type:Individual
Prefix:
First Name:RAJAN
Middle Name:S
Last Name:KARUVELANKULAM SUBBIAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:155 CRYSTAL RUN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-4028
Mailing Address - Country:US
Mailing Address - Phone:845-703-6999
Mailing Address - Fax:845-703-6297
Practice Address - Street 1:61 EMERALD PL
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:NY
Practice Address - Zip Code:12775-6049
Practice Address - Country:US
Practice Address - Phone:845-794-6999
Practice Address - Fax:845-703-6297
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2020-10-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY275015207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03221712Medicaid
NYA400043772Medicare PIN