Provider Demographics
NPI:1265637284
Name:PRIME HEALTH MEDICAL PC
Entity type:Organization
Organization Name:PRIME HEALTH MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROHATGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-746-0422
Mailing Address - Street 1:31 GERALIND DR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-2415
Mailing Address - Country:US
Mailing Address - Phone:516-746-0422
Mailing Address - Fax:516-279-4465
Practice Address - Street 1:623 STEWART AVE STE 201
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4771
Practice Address - Country:US
Practice Address - Phone:516-746-0422
Practice Address - Fax:516-279-4465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03280086Medicaid
NYP3714426OtherOXFORD