Provider Demographics
NPI:1720237126
Name:RAJAN, NARASANNA (MD FCCP)
Entity Type:Individual
Prefix:DR
First Name:NARASANNA
Middle Name:
Last Name:RAJAN
Suffix:
Gender:M
Credentials:MD FCCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 HAMILL RD
Mailing Address - Street 2:1540 SP VALLEY RD
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-4755
Mailing Address - Country:US
Mailing Address - Phone:304-429-6741
Mailing Address - Fax:
Practice Address - Street 1:76 HAMILL RD
Practice Address - Street 2:1540 SP VALLEY RD
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-4755
Practice Address - Country:US
Practice Address - Phone:304-429-6741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118518146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant