Provider Demographics
NPI:1326323106
Name:MAHARAJ, GANGARAM SATEESH (RPH)
Entity Type:Individual
Prefix:MR
First Name:GANGARAM
Middle Name:SATEESH
Last Name:MAHARAJ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 COTTAGE STREET
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-2806
Mailing Address - Country:US
Mailing Address - Phone:201-656-2244
Mailing Address - Fax:201-792-4230
Practice Address - Street 1:47 COTTAGE STREET
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2806
Practice Address - Country:US
Practice Address - Phone:201-656-2244
Practice Address - Fax:201-792-4230
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RIO16556001835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist