Provider Demographics
NPI:1346566403
Name:PANJU-MERALI, RUBAB RUBY (FNP)
Entity Type:Individual
Prefix:MS
First Name:RUBAB
Middle Name:RUBY
Last Name:PANJU-MERALI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:RUBAB (RUBY)
Other - Middle Name:
Other - Last Name:MERALI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-933-4380
Mailing Address - Fax:
Practice Address - Street 1:6201 GREENLEIGH AVE
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-2004
Practice Address - Country:US
Practice Address - Phone:410-933-4380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1010065771363LF0000X
DCRN1045319363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily