Provider Demographics
NPI:1013112622
Name:DHARMARAJAN, KAVITA V (MD)
Entity type:Individual
Prefix:DR
First Name:KAVITA
Middle Name:V
Last Name:DHARMARAJAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KAVITA
Other - Middle Name:B
Other - Last Name:VYAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1184 FIFTH AVE, 1ST FLOOR
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:214-734-8953
Mailing Address - Fax:
Practice Address - Street 1:1184 5TH AVE FL 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6503
Practice Address - Country:US
Practice Address - Phone:214-734-8953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-231913208000000X
NY2542702085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics