Provider Demographics
NPI:1780668830
Name:SANIKOP, RAJENDRA (MD)
Entity Type:Individual
Prefix:
First Name:RAJENDRA
Middle Name:
Last Name:SANIKOP
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 1:910 MEADOW RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-5574
Mailing Address - Country:US
Mailing Address - Phone:410-420-8427
Mailing Address - Fax:
Practice Address - Street 1:7702 DUNMANWAY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21222-5436
Practice Address - Country:US
Practice Address - Phone:410-282-1792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00410772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH93135Medicare UPIN