Provider Demographics
NPI:1124183017
Name:VAZIRANI, MINAL (MD)
Entity Type:Individual
Prefix:DR
First Name:MINAL
Middle Name:
Last Name:VAZIRANI
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 1:200 S ORANGE AVE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5817
Mailing Address - Country:US
Mailing Address - Phone:973-322-7007
Mailing Address - Fax:973-322-7436
Practice Address - Street 1:200 S ORANGE AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5817
Practice Address - Country:US
Practice Address - Phone:973-322-7007
Practice Address - Fax:973-322-7436
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY247683207R00000X, 208000000X
NJ25MA08107300207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics