Provider Demographics
NPI:1689647695
Name:LAROIA, RAHUL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:
Last Name:LAROIA
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 1:43 WILLOW POND WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-2638
Mailing Address - Country:US
Mailing Address - Phone:585-377-5420
Mailing Address - Fax:585-377-3690
Practice Address - Street 1:43 WILLOW POND WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-2638
Practice Address - Country:US
Practice Address - Phone:585-377-5420
Practice Address - Fax:585-377-3690
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203291207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG29303Medicare UPIN
NYCC7314Medicare ID - Type Unspecified