NPIMap

Organization Active NPI

Rajesh Mariwalla, MD PC

  • Pediatrics Physician
  • West Islip, NY
National Provider Identifier
1457741035
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
153786 Issued in NY
Legal business name
RAJESH MARIWALLA, MD PC
Practice address
1175 Montauk Hwy
Suite 4
West Islip, NY 11795-4939
Phone
(631) 422-9600
Fax
(631) 422-9697
NPI assigned
Feb 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Authorized official

Name
Dr. Rajesh Mariwalla, MDNPI 1740378629
Title
MD
Phone
(631) 422-9600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 153786 NY Primary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 217202 NY
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 209194 NY
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X 008888 NY

Addresses

Primary practice location

1175 Montauk Hwy
Suite 4
West Islip, NY 11795-4939

Mailing address

1175 Montauk Hwy
Suite 4
West Islip, NY 11795-4939
Phone (631) 422-9600

National Provider Directory

National Provider Directory

Locations

1175 Montauk Hwy
Ste 4
West Islip, NY 11795
Phone (631) 422-9600

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424217600000",
    "number": "1457741035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 MONTAUK HWY",
            "address_2": "SUITE 4",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954939",
            "telephone_number": "631-422-9600",
            "fax_number": "631-422-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 MONTAUK HWY",
            "address_2": "SUITE 4",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954939",
            "telephone_number": "631-422-9600",
            "fax_number": "631-422-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAJESH MARIWALLA, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-03",
        "last_updated": "2015-02-18",
        "status": "A",
        "authorized_official_last_name": "MARIWALLA",
        "authorized_official_first_name": "RAJESH",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "631-422-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "153786",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "217202",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "209194",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008888",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.