Basic Information
Provider Information
NPI: 1740345222
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BORKAR
FirstName: RAJENDRA
MiddleName: JAIDEV
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2101 E JEFFERSON ST
Address2: KAISER PERMANENTE PPQA DEPT 6 WEST ATTN THERESA BROOKS
City: ROCKVILLE
State: MD
PostalCode: 208524908
CountryCode: US
TelephoneNumber: 3018166660
FaxNumber: 3018166308
Practice Location
Address1: 201 N WASHINGTON ST
Address2:  
City: FALLS CHURCH
State: VA
PostalCode: 220464518
CountryCode: US
TelephoneNumber: 7032374079
FaxNumber: 7035361551
Other Information
ProviderEnumerationDate: 12/26/2006
LastUpdateDate: 11/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X0101053700VAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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