1184606139 NPI number — DR. SAROJINI RADHAKRISHNAN MD

Table of content: DR. SAROJINI RADHAKRISHNAN MD (NPI 1184606139)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184606139 NPI number — DR. SAROJINI RADHAKRISHNAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RADHAKRISHNAN
Provider First Name:
SAROJINI
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184606139
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
970 N BROADWAY STE 104
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YONKERS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10701-1310
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-296-3454
Provider Business Mailing Address Fax Number:
914-296-3493

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
970 N BROADWAY STE 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YONKERS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10701-1310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-886-2446
Provider Business Practice Location Address Fax Number:
914-631-3850
Provider Enumeration Date:
11/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  230777 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0288227 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 12276560 . This is a "MULTIPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: P3566180 . This is a "OXFORD PIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02529546 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2408345 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5996441 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3315P1 . This is a "BCBS PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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