Provider Demographics
NPI:1043698608
Name:NYC METRO ENT PC
Entity type:Organization
Organization Name:NYC METRO ENT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJENDRA
Authorized Official - Middle Name:D
Authorized Official - Last Name:BHAYANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-645-2555
Mailing Address - Street 1:PO BOX 230207
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-0207
Mailing Address - Country:US
Mailing Address - Phone:718-645-2555
Mailing Address - Fax:718-645-1333
Practice Address - Street 1:6273 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2832
Practice Address - Country:US
Practice Address - Phone:718-595-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60 108506207YX0007X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Multi-Specialty