Provider Demographics
NPI:1417944190
Name:BANSAL, RAJNISH (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJNISH
Middle Name:
Last Name:BANSAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DAVOL SQ
Mailing Address - Street 2:STE 400
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4754
Mailing Address - Country:US
Mailing Address - Phone:401-421-4000
Mailing Address - Fax:401-272-1456
Practice Address - Street 1:900 WARREN AVE
Practice Address - Street 2:STE 400
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-1430
Practice Address - Country:US
Practice Address - Phone:401-331-1221
Practice Address - Fax:401-751-8003
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD10218207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI10240OtherNEIGHBORHOOD HEALTH PLAN
RI406635OtherBLUE CHIP
RI04-02810OtherUNITED HEALTH CARE
RI0540483739OtherGREAT WEST HEALTH CARE
RI110193084OtherRAILROAD MEDICARE
RI710046201OtherCIGNA
RI69821OtherHARVARD HEALTH PLAN
RI709004159OtherMEDICARE GROUP
RI22011OtherBCBS OF RI
RI402478OtherTUFTS HEALTH PLAN
RI9022011Medicaid
RI709004159OtherMEDICARE GROUP
RI050483739OtherTIN #
RI69821OtherHARVARD HEALTH PLAN