1649478322 NPI number — NARESH RANA MD PA

Table of content: (NPI 1649478322)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649478322 NPI number — NARESH RANA MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NARESH RANA MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649478322
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
627 ALBERTA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARAMUS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07652-4801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-743-7707
Provider Business Mailing Address Fax Number:
973-743-7808

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
733 BLOOMFIELD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLOOMFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07003-2545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-743-7707
Provider Business Practice Location Address Fax Number:
973-743-7808
Provider Enumeration Date:
07/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RANA
Authorized Official First Name:
NARESH
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
973-743-7707

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MA52992 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 118118 . This is a "MEDICARE ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 5014301 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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