Provider Demographics
NPI:1841477353
Name:RAO, PAUL GURUDATH (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:GURUDATH
Last Name:RAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:93 EDWARDS ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-3933
Mailing Address - Country:US
Mailing Address - Phone:203-772-1270
Mailing Address - Fax:203-772-0051
Practice Address - Street 1:93 EDWARDS ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3933
Practice Address - Country:US
Practice Address - Phone:203-772-1270
Practice Address - Fax:203-772-0051
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0466872084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry