Provider Demographics
NPI:1417997115
Name:MALIK, RAJESH (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:
Last Name:MALIK
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 1:110 WILLOW OAKS LN
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-4536
Mailing Address - Country:US
Mailing Address - Phone:856-223-9446
Mailing Address - Fax:856-478-4709
Practice Address - Street 1:201 BRIDGETON PIKE
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-2671
Practice Address - Country:US
Practice Address - Phone:856-478-2111
Practice Address - Fax:856-478-4709
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07610600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1740381680OtherNPI NUMBER
NJ074007B67Medicare PIN
NJ074007Medicare PIN
NJ106670Medicare PIN
1740381680OtherNPI NUMBER