Provider Demographics
NPI:1295066637
Name:NOG, RAJAT (MD)
Entity type:Individual
Prefix:
First Name:RAJAT
Middle Name:
Last Name:NOG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:19 BRADHURST AVE
Mailing Address - Street 2:SUITE 3100N
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2140
Mailing Address - Country:US
Mailing Address - Phone:914-909-9018
Mailing Address - Fax:914-909-9028
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-493-8916
Practice Address - Fax:914-493-1097
Is Sole Proprietor?:No
Enumeration Date:2010-01-25
Last Update Date:2016-03-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT048515207RI0200X
NY277229207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001485150Medicaid
CTPENDING - C00023Medicare PIN
CTPENDING - C00814Medicare PIN