Provider Demographics
NPI:1184606139
Name:RADHAKRISHNAN, SAROJINI (MD)
Entity type:Individual
Prefix:DR
First Name:SAROJINI
Middle Name:
Last Name:RADHAKRISHNAN
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 1:970 N BROADWAY STE 104
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1310
Mailing Address - Country:US
Mailing Address - Phone:914-296-3454
Mailing Address - Fax:914-296-3493
Practice Address - Street 1:970 N BROADWAY STE 104
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1310
Practice Address - Country:US
Practice Address - Phone:914-886-2446
Practice Address - Fax:914-631-3850
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2024-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230777207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0288227OtherCIGNA
12276560OtherMULTIPLAN
P3566180OtherOXFORD PIN
NY02529546Medicaid
2408345OtherUNITED HEALTHCARE
5996441OtherGHI
NY3315P1OtherBCBS PIN
NY02529546Medicaid
2408345OtherUNITED HEALTHCARE