| Rajashree Kantha, M.d., P.a. | |
|
1124 E Ridgewood Ave Ste 102 Ridgewood NJ 07450-3943 | |
| (201) 445-7744 | |
| (201) 445-7767 |
| Full Name | Rajashree Kantha, M.d., P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 1124 E Ridgewood Ave Ste 102, Ridgewood, New Jersey |
| Authorized Official Name and Position | Rajashree Kantha (MEDICAL DOCTOR) |
| Authorized Official Contact | 2014457744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rajashree Kantha, M.d., P.a. 1124 E Ridgewood Ave Ste 102 Ridgewood NJ 07450-3943 Ph: (201) 445-7744 | Rajashree Kantha, M.d., P.a. 1124 E Ridgewood Ave Ste 102 Ridgewood NJ 07450-3943 Ph: (201) 445-7744 |
| NPI Number | 1184888091 |
|---|---|
| Provider Enumeration Date | 07/10/2008 |
| Last Update Date | 03/25/2021 |
| Medicare PECOS PAC ID | 7416975990 |
|---|---|
| Medicare Enrollment ID | O20051115000006 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184888091 | NPI | - | NPPES |
| 0110617 | Other | NJ | GHI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MA07366300 (New Jersey) | Primary |
| Provider Name | Rajashree K Bhatnagar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417991381 PECOS PAC ID: 5799703971 Enrollment ID: I20051114000139 |
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