Provider Demographics
NPI:1164491585
Name:ALMANZAR, RAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:
Last Name:ALMANZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-8512
Mailing Address - Country:US
Mailing Address - Phone:973-458-8000
Mailing Address - Fax:973-458-8427
Practice Address - Street 1:913 MAIN AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-8512
Practice Address - Country:US
Practice Address - Phone:973-458-8000
Practice Address - Fax:973-458-8427
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06599400208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8220721Medicaid