Basic Information
Provider Information | |||||||||
NPI: | 1831205053 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | RAO | ||||||||
FirstName: | HARSHIT | ||||||||
MiddleName: | S | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 82 LINCOLN AVE | ||||||||
Address2: |   | ||||||||
City: | PISCATAWAY | ||||||||
State: | NJ | ||||||||
PostalCode: | 088544866 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7326661015 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 1 ROBERT WOOD JOHNSON PL | ||||||||
Address2: | MEB 564 | ||||||||
City: | NEW BRUNSWICK | ||||||||
State: | NJ | ||||||||
PostalCode: | 089011928 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7322357840 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 08/21/2006 | ||||||||
LastUpdateDate: | 06/16/2014 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 25MA08037200 | NJ | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207R00000X | P8301 | TX | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207RP1001X | P8301 | TX | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
ID | Type | State | Issuer | Description | 329406802 | 05 | TX |   | MEDICAID | 329406803 | 05 | TX |   | MEDICAID | 329406801 | 05 | TX |   | MEDICAID | P01300296 | 01 | TX | MEDICARE RAILROAD | OTHER | 0110787 | 05 | NJ |   | MEDICAID |