Phavalan Rajendram, MD, FRCPC

Primary specialty

Vascular Neurology PhysicianTaxonomy code 2084V0102X

License

292405 Issued in MA

Practice address

330 Brookline Avenue
Palmer 127
Boston, MA 02215

Phone

(617) 632-8980

Fax

(617) 632-8920

NPI assigned

Jul 19, 2022

Sex

Male

Sole proprietor

No

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

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1942935333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 CAMBRIDGEPARK DR UNIT 452",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021402497",
            "telephone_number": "781-460-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVENUE",
            "address_2": "PALMER 127",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-632-8980",
            "fax_number": "617-632-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJENDRAM",
        "first_name": "PHAVALAN",
        "name_prefix": "Dr.",
        "credential": "MD, FRCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "MA",
            "license": "292405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prashanth Rajarajan, MD, PHD
• Ruma Rajbhandari
• Noopur Suresh Raje, MD
• Praachi Raje, MD
• Hamid Rajebi, MD
• Jashmi Rajendran, PHARMD
• Pradeep Sundaram Rajendran, MD, PHD
• Rahul Rajkumar, M.D., J.D.
• Rachna Rajpal, RDN
• Neha Rajput

• Vascular Neurology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Vascular Neurology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.