Basic Information
| Provider Information | |||||||||
| NPI: | 1619504685 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RATTAN | ||||||||
| FirstName: | JUHI | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| OtherLastName: | RATTAN | ||||||||
| OtherFirstName: | JUHI | ||||||||
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| OtherCredential: | MD, MS | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1 MEDICAL DR DEPT OF | ||||||||
| Address2: | |||||||||
| City: | LEBANON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 037561000 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | ONE MEDICAL CENTER DR | ||||||||
| Address2: | DHMC DEPT OF PEDIATRICS | ||||||||
| City: | LEBANON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 037560001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036536080 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2020 | ||||||||
| LastUpdateDate: | 03/26/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | NH | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.