Provider Demographics
NPI:1942284930
Name:SENGUPTA, RAHUL (MD)
Entity Type:Individual
Prefix:
First Name:RAHUL
Middle Name:
Last Name:SENGUPTA
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 1:15 CATHEDRAL OAKS
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-4215
Mailing Address - Country:US
Mailing Address - Phone:585-383-0942
Mailing Address - Fax:
Practice Address - Street 1:59 MONROE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-1308
Practice Address - Country:US
Practice Address - Phone:585-385-1710
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212140208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7525340OtherAETNA PROVIDER NUMBER
NY01945257Medicaid
NYP01021240OtherBLUE CHOICE PROVIDER NUMB
NY0009265029001OtherHEALTHNOW PROVIDER NUMBER
NY101788DLOtherPREFERRED CARE
NY1843OtherEXCELLUS BLS