Provider Demographics
NPI:1912562067
Name:RAKHI SUTARIA MD PC
Entity Type:Organization
Organization Name:RAKHI SUTARIA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAKHI
Authorized Official - Middle Name:GARG
Authorized Official - Last Name:SUTARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-761-5220
Mailing Address - Street 1:11107 77TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11375-7044
Mailing Address - Country:US
Mailing Address - Phone:516-761-5220
Mailing Address - Fax:
Practice Address - Street 1:11203 QUEENS BLVD STE 209
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5550
Practice Address - Country:US
Practice Address - Phone:516-761-5220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-03
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty