Provider Demographics
NPI:1245478486
Name:RAJMANE, KIRAN CHANDRAKANT (MD)
Entity type:Individual
Prefix:DR
First Name:KIRAN
Middle Name:CHANDRAKANT
Last Name:RAJMANE
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 1:211 N END AVE
Mailing Address - Street 2:APT 14Q
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10282-1222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:211 N END AVE
Practice Address - Street 2:APT 14Q
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10282-1222
Practice Address - Country:US
Practice Address - Phone:267-253-3809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD686702085B0100X
NJ25MA080343002085B0100X
NY2586342085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD022638600Medicaid
MD022638600Medicaid