Provider Demographics
NPI:1205835436
Name:JIANDANI, RAMA PRATAP (MSW)
Entity Type:Individual
Prefix:MS
First Name:RAMA
Middle Name:PRATAP
Last Name:JIANDANI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:RAMA
Other - Middle Name:PRATAP
Other - Last Name:JIANDANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:35 S SHORE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08879-3433
Mailing Address - Country:US
Mailing Address - Phone:732-602-9000
Mailing Address - Fax:732-636-4000
Practice Address - Street 1:35 S SHORE DR
Practice Address - Street 2:
Practice Address - City:SOUTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08879-3433
Practice Address - Country:US
Practice Address - Phone:732-602-9000
Practice Address - Fax:732-636-4000
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC010237001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0056944Medicaid
NJ080759SXQMedicare ID - Type Unspecified
NJN6203Medicare UPIN