Provider Demographics
NPI:1073522819
Name:DHIRMALANI, RAJESH A (DO)
Entity Type:Individual
Prefix:MR
First Name:RAJESH
Middle Name:A
Last Name:DHIRMALANI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 MORRIS AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083
Mailing Address - Country:US
Mailing Address - Phone:908-851-2770
Mailing Address - Fax:908-851-9023
Practice Address - Street 1:1308 MORRIS AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083
Practice Address - Country:US
Practice Address - Phone:908-851-2770
Practice Address - Fax:908-851-9023
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001803207R00000X
NJ25MB07250700207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAH73588Medicare UPIN