Provider Demographics
NPI:1871793992
Name:NEW YORK OTOLARYNGOLOGY & AESTHETIC SURGERY PC
Entity type:Organization
Organization Name:NEW YORK OTOLARYNGOLOGY & AESTHETIC SURGERY PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
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:718-249-9383
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:718-249-9383
Mailing Address - Fax:718-645-1333
Practice Address - Street 1:1783 W 6TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1321
Practice Address - Country:US
Practice Address - Phone:718-645-2555
Practice Address - Fax:718-645-1333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226427207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH93821Medicare UPIN