Provider Demographics
NPI:1659605186
Name:AGASHIWALA, RAJIV MAHESH (DO)
Entity Type:Individual
Prefix:DR
First Name:RAJIV
Middle Name:MAHESH
Last Name:AGASHIWALA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2265 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-2231
Mailing Address - Country:US
Mailing Address - Phone:212-289-6650
Mailing Address - Fax:212-360-6149
Practice Address - Street 1:2265 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-2231
Practice Address - Country:US
Practice Address - Phone:212-289-6650
Practice Address - Fax:212-360-6149
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254617207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine