Provider Demographics
NPI:1033607973
Name:KOUL, RESHMA RAJNIKANT (MD)
Entity Type:Individual
Prefix:DR
First Name:RESHMA
Middle Name:RAJNIKANT
Last Name:KOUL
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 1:115 CHRISTOPHER COLUMBUS DR STE 301
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3551
Mailing Address - Country:US
Mailing Address - Phone:201-268-5636
Mailing Address - Fax:
Practice Address - Street 1:115 CHRISTOPHER COLUMBUS DR STE 301
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3551
Practice Address - Country:US
Practice Address - Phone:201-268-5636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11323100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine