Provider Demographics
NPI:1700564929
Name:RAGOOR FAMILY PRACTICE LLC
Entity Type:Organization
Organization Name:RAGOOR FAMILY PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BALAKRISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGOOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-469-1111
Mailing Address - Street 1:4217 NORTHERN PIKE
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2713
Mailing Address - Country:US
Mailing Address - Phone:412-699-5993
Mailing Address - Fax:412-699-1430
Practice Address - Street 1:4217 NORTHERN PIKE
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2713
Practice Address - Country:US
Practice Address - Phone:412-699-5993
Practice Address - Fax:412-699-1430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty