Provider Demographics
NPI:1265511877
Name:BHARDWAJ, RAKESH K (MD)
Entity type:Individual
Prefix:DR
First Name:RAKESH
Middle Name:K
Last Name:BHARDWAJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8945 SPRINGFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2513
Mailing Address - Country:US
Mailing Address - Phone:718-217-2300
Mailing Address - Fax:718-740-5374
Practice Address - Street 1:8945 SPRINGFIELD BLVD
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-2513
Practice Address - Country:US
Practice Address - Phone:718-217-2300
Practice Address - Fax:718-740-5374
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY187625207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01558112Medicaid
NY01558112Medicaid
NY01785GMedicare ID - Type Unspecified