1528256591 NPI number — RAJESHWARI DORAISWAMY

Table of content: RAJESHWARI DORAISWAMY (NPI 1528256591)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528256591 NPI number — RAJESHWARI DORAISWAMY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DORAISWAMY
Provider First Name:
RAJESHWARI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DORASWAMY
Provider Other First Name:
RAJI
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
R.P.T
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1528256591
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/04/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 241
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOWACO
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07082-0241
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
706 ROUTE 15 SOUTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKE HOPATCONG
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07849-2250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-663-5925
Provider Business Practice Location Address Fax Number:
973-663-4052
Provider Enumeration Date:
10/04/2007

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: 225100000X , with the licence number:  40QAOO273300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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