Provider Demographics
NPI:1144407446
Name:RAJAN PASTORIZA MD PLC
Entity type:Organization
Organization Name:RAJAN PASTORIZA MD PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:PASTORIZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-787-6838
Mailing Address - Street 1:1100 E MICHIGAN AVE
Mailing Address - Street 2:STE 205
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1847
Mailing Address - Country:US
Mailing Address - Phone:517-787-6838
Mailing Address - Fax:517-787-5623
Practice Address - Street 1:1100 E MICHIGAN AVE
Practice Address - Street 2:STE 205
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1847
Practice Address - Country:US
Practice Address - Phone:517-787-6838
Practice Address - Fax:517-787-5623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0N91880Medicare PIN