Provider Demographics
NPI:1104602275
Name:BEDEKAR, RASHI SANJAY (MD)
Entity type:Individual
Prefix:
First Name:RASHI
Middle Name:SANJAY
Last Name:BEDEKAR
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 1:6970 GRAND CENTRAL PKWY
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3949
Mailing Address - Country:US
Mailing Address - Phone:718-263-4600
Mailing Address - Fax:212-849-0965
Practice Address - Street 1:6970 GRAND CENTRAL PKWY
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3949
Practice Address - Country:US
Practice Address - Phone:973-429-6196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP123697207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program