Sujatha Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SUJATHA MEDICAL PC

Practice address

21414 Hillside Ave
Queens Village, NY 11427-1808

Phone

(718) 264-2700

Fax

(718) 264-2702

NPI assigned

Feb 11, 2007

Organization subpart

No

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

Authorized official

Name

Sujatha Rajan, M.DNPI 1578593323

Title

Medical Doctor

Phone

(718) 264-2700

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

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

• Sujatha Rajan, M.D

  • Internal Medicine Physician
  • Queens Village, NY
  • NPI 1578593323
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1720129737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6636 YELLOWSTONE BLVD",
            "address_2": "APT. 18F",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752510",
            "telephone_number": "718-264-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21414 HILLSIDE AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114271808",
            "telephone_number": "718-264-2700",
            "fax_number": "718-264-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUJATHA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-11",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "RAJAN",
        "authorized_official_first_name": "SUJATHA",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "718-264-2700",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - GHI",
            "identifier": "07554",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nikia Stubbs, OTA
• Angel Suarez, LMFT, ABS
• Beverly S Suarez
• Shanta Subdhan
• Jensy Subin
• Ellen J Sullivan, DDS
• Gail Ellen Sumler, LCSW
• Yibo Sun, PHARM D
• Zhenjiang Sun, M.D.
• Usha Sunilkumar

• Internal Medicine Physician in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.