Provider Demographics
NPI:1386645638
Name:BALLAL, RAJ (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJ
Middle Name:
Last Name:BALLAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:622 GEORGES RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-3377
Mailing Address - Country:US
Mailing Address - Phone:732-745-4994
Mailing Address - Fax:732-745-7044
Practice Address - Street 1:98 JAMES ST
Practice Address - Street 2:SUITE 300
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3902
Practice Address - Country:US
Practice Address - Phone:732-548-2523
Practice Address - Fax:732-549-8827
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2010-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA65996207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7560605Medicaid
NJ7560605Medicaid
NJF55385Medicare UPIN