Provider Demographics
NPI:1114471372
Name:RAMBARAN, CHRISTOPHER AARON
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:AARON
Last Name:RAMBARAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 BLACKBURN RD
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-2522
Mailing Address - Country:US
Mailing Address - Phone:908-553-7094
Mailing Address - Fax:
Practice Address - Street 1:58 BLACKBURN RD
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205-2522
Practice Address - Country:US
Practice Address - Phone:908-553-7094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-05
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00658300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily