Individual ProviderBenamanahalli K RajegowdaSpecialistOther Service ProvidersPractice Address234 E 149th St, Bronx, NY 10451-5504(718) 579-5360PECOS EnrollmentBased on the most recent information from CMS, provider Benamanahalli K Rajegowda does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:00 AM.Profile DetailsProvider ID1295895852Provider TypeIndividualFull NameRajegowda, Benamanahalli KTitleDr.CredentialM.DGenderMaleSole ProprietorNoEnumeration Date12/12/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address234 E 149th St, Bronx, NY 10451-5504Phone(718) 579-5360Fax(718) 579-4958Mailing LocationMailing Address237 S Greenbush Rd, Orangeburg, NY 10962-1324Phone(718) 579-5360Fax(718) 579-4958Provider TaxonomiesCodeDescriptionLicenseCode174400000XPrimaryDescriptionSpecialistOther Service ProvidersLicense111700-1New York