Provider Demographics
NPI:1407856792
Name:GREWAL, RAJI P (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJI
Middle Name:P
Last Name:GREWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 K JOHNSON BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-2275
Mailing Address - Country:US
Mailing Address - Phone:609-537-7300
Mailing Address - Fax:609-537-7301
Practice Address - Street 1:100 K JOHNSON BLVD STE 201
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-2275
Practice Address - Country:US
Practice Address - Phone:609-537-7300
Practice Address - Fax:609-537-7301
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA069146002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
9102349OtherAETNA PPO
P1730536OtherOXFORD HEALTH PLANS
1739289OtherUNITED HEALTHCARE COMMERCIAL AND MEDICARE
2240147OtherCIGNA
21861020OtherKEYSTONE HEALTH PLAN EAST PCP
NJ218610200OtherAMERIHEALTH
NJ261649038OtherHORIZON BCBS
P0097929OtherRAILROAD MEDICARE
NJ60067907OtherHORIZON NJ HEALTH
NJ8215502Medicaid
21861020OtherKEYSTONE HEALTH PLAN EAST PCP
NJ261649038OtherHORIZON BCBS