Gavoury Rajendran, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

013872-1 Issued in NY

Practice address

616 Klondike Ave
Staten Island, NY 10314-6106

Phone

(718) 761-4672

Fax

(718) 370-0884

NPI assigned

Oct 29, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225238400000",
    "number": "1205089570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 KLONDIKE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146106",
            "telephone_number": "718-761-4672",
            "fax_number": "718-370-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 KLONDIKE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146106",
            "telephone_number": "718-761-4672",
            "fax_number": "718-370-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJENDRAN",
        "first_name": "GAVOURY",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-29",
        "last_updated": "2008-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "013872-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Joseph Raiola, PHYSICIAN ASSISTANT
• Jeane Rajacic-Poppe, PH.D
• Benjamin Rajan, DO
• Anisha Nikki Rajavel, D.O.
• Ahmad Rajeh
• Raeshmma Rajesh, MD
• Grace Raju, PHARM.D
• Jaya Raju, BS
• Kochuvila K. Raju, MD
• Raghava Raju, MD

• Physical Therapist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.