Individual ProviderSudha RaoSpecialistOther Service ProvidersPractice Address234 Esat 149th Street, Department Of Pediatric Room 420, Bronx, NY 10451(718) 579-5360(718) 945-7150PECOS EnrollmentBased on the most recent information from CMS, provider Sudha Rao is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 8:41 AM.Profile DetailsProvider ID1851455752Provider TypeIndividualFull NameRao, SudhaTitleDr.CredentialM.DGenderFemaleSole ProprietorNoEnumeration Date12/22/2006Last Updated5/8/2013Contact InformationPractice LocationPractice Address234 Esat 149th Street, Department Of Pediatric Room 420, Bronx, NY 10451Phone(718) 579-5360Fax(718) 579-4958Mailing LocationMailing Address6200 Beach Channel Dr, Arverne, NY 11692-1409Phone(718) 945-7150Fax(718) 945-2596Provider TaxonomiesCodeDescriptionLicenseCode174400000XPrimaryDescriptionSpecialistOther Service ProvidersLicense1318641New YorkProvider IdentifiersIDDescriptionIssuerID00894266DescriptionMedicaidIssuerUnlistedNew York