Provider Demographics
NPI:1356845622
Name:ANAND, ROMA (NP)
Entity Type:Individual
Prefix:
First Name:ROMA
Middle Name:
Last Name:ANAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 KEARNY AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-2437
Mailing Address - Country:US
Mailing Address - Phone:201-997-0808
Mailing Address - Fax:
Practice Address - Street 1:2665 N DECATUR RD STE 230
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6136
Practice Address - Country:US
Practice Address - Phone:404-499-0533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00814700363LA2200X
GARN262105363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty