Basic Information
| Provider Information | |||||||||
| NPI: | 1174785802 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MURALIDHARAN | ||||||||
| FirstName: | RAJANANDINI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1530 FRONT ST STE 400 | ||||||||
| Address2: | |||||||||
| City: | EAST MEADOW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115542265 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163247500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 222 STATION PLZ N | ||||||||
| Address2: | SUITE 408 | ||||||||
| City: | MINEOLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115013800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166634852 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2008 | ||||||||
| LastUpdateDate: | 08/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 51211 | MN | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084A2900X | 270-901 | NY | N |
No ID Information.