Basic Information
| Provider Information | |||||||||
| NPI: | 1801092135 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KOTECHA | ||||||||
| FirstName: | RACHANA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | JANI | ||||||||
| OtherFirstName: | RACHANA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1790 BROADWAY | ||||||||
| Address2: | SUITE 1802 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100191412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125300624 | ||||||||
| FaxNumber: | 2128674353 | ||||||||
| Practice Location | |||||||||
| Address1: | 1790 BROADWAY | ||||||||
| Address2: | SUITE 1802 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100191412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125300624 | ||||||||
| FaxNumber: | 2128674353 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2007 | ||||||||
| LastUpdateDate: | 11/10/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 255879 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.