Provider Demographics
NPI:1619915725
Name:RAJAN, SWAMINATHAN (MD)
Entity Type:Individual
Prefix:
First Name:SWAMINATHAN
Middle Name:
Last Name:RAJAN
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 1:6 CLARA LN
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-3106
Mailing Address - Country:US
Mailing Address - Phone:845-367-2094
Mailing Address - Fax:845-803-8682
Practice Address - Street 1:6 CLARA LN
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-3106
Practice Address - Country:US
Practice Address - Phone:845-367-2094
Practice Address - Fax:845-803-8682
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160910207XS0106X, 2086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01037461Medicaid
NY13E631Medicare PIN
NY01037461Medicaid