Provider Demographics
NPI:1003838723
Name:RAMACHANDRA RAO, VANIE S (MD)
Entity Type:Individual
Prefix:DR
First Name:VANIE
Middle Name:S
Last Name:RAMACHANDRA RAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 HUMMINGBIRD CT
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-2511
Mailing Address - Country:US
Mailing Address - Phone:732-797-2351
Mailing Address - Fax:
Practice Address - Street 1:14 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6402
Practice Address - Country:US
Practice Address - Phone:732-244-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07491200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I34390Medicare UPIN
NJ0925300A3Medicare ID - Type Unspecified