Provider Demographics
NPI:1801058300
Name:NARAIN, RAJIV KEVIN (PA)
Entity type:Individual
Prefix:
First Name:RAJIV
Middle Name:KEVIN
Last Name:NARAIN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10310 91ST ST
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417-1302
Mailing Address - Country:US
Mailing Address - Phone:718-641-3457
Mailing Address - Fax:
Practice Address - Street 1:10310 91ST ST
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11417-1302
Practice Address - Country:US
Practice Address - Phone:718-641-3457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012312363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant