Provider Demographics
NPI:1801189568
Name:SUTARIA, RAKHI GARG (MD)
Entity Type:Individual
Prefix:
First Name:RAKHI
Middle Name:GARG
Last Name:SUTARIA
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 1:11107 77TH AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-7044
Mailing Address - Country:US
Mailing Address - Phone:516-761-5220
Mailing Address - Fax:888-720-0257
Practice Address - Street 1:2705 WILLIAMSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-4109
Practice Address - Country:US
Practice Address - Phone:516-761-5220
Practice Address - Fax:888-720-0257
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT556582081S0010X
NY2968722081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine