Provider Demographics
NPI:1255325957
Name:MOTIWALA, RAJEEV S (MD)
Entity type:Individual
Prefix:DR
First Name:RAJEEV
Middle Name:S
Last Name:MOTIWALA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:5 E 98TH ST
Mailing Address - Street 2:BOX 1139
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6501
Mailing Address - Country:US
Mailing Address - Phone:212-271-7076
Mailing Address - Fax:212-987-3301
Practice Address - Street 1:5 E 98TH ST
Practice Address - Street 2:BOX 1139
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6501
Practice Address - Country:US
Practice Address - Phone:212-271-7076
Practice Address - Fax:212-987-3301
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2337162084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1148605Medicaid
NJ99829Medicare ID - Type Unspecified
E52210Medicare UPIN