Provider Demographics
NPI:1770038408
Name:SUNITA M RAJPUT DO, LLC
Entity Type:Organization
Organization Name:SUNITA M RAJPUT DO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNITA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAJPUT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:505-835-6784
Mailing Address - Street 1:8100 WYOMING BLVD NE
Mailing Address - Street 2:SUITE M4, BOX 384
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1946
Mailing Address - Country:US
Mailing Address - Phone:505-835-6784
Mailing Address - Fax:505-837-4610
Practice Address - Street 1:100 SUN AVE NE
Practice Address - Street 2:SUITE 650
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4659
Practice Address - Country:US
Practice Address - Phone:505-835-6784
Practice Address - Fax:505-837-4610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA1528092081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty