Provider Demographics
NPI:1689704975
Name:BEHARRY, RANI (MD)
Entity Type:Individual
Prefix:DR
First Name:RANI
Middle Name:
Last Name:BEHARRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1047 RIVER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-8277
Mailing Address - Country:US
Mailing Address - Phone:203-645-2903
Mailing Address - Fax:
Practice Address - Street 1:130 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-4070
Practice Address - Country:US
Practice Address - Phone:203-645-2903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101243511207R00000X
DEC1-0008582207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1689704975Medicaid
VA1248110001Medicare NSC
VA00X835A02Medicare PIN
VAP00657807Medicare PIN