Provider Demographics
NPI:1447275904
Name:RAO, BABAR K (MD)
Entity type:Individual
Prefix:
First Name:BABAR
Middle Name:K
Last Name:RAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:66 W GILBERT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4947
Mailing Address - Country:US
Mailing Address - Phone:732-212-0051
Mailing Address - Fax:732-212-0713
Practice Address - Street 1:35 E 35TH ST
Practice Address - Street 2:STE 208
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3823
Practice Address - Country:US
Practice Address - Phone:212-684-6140
Practice Address - Fax:212-689-5748
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA79859207N00000X
NJ25MA07004000207ND0900X, 207N00000X
NY211630207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8298700Medicaid
NY2K6002Medicare ID - Type Unspecified
NJ041103BDKMedicare PIN
G98454Medicare UPIN
NJ8298700Medicaid