Provider Demographics
NPI:1437135951
Name:RAMAN, RAJESH C (MD)
Entity Type:Individual
Prefix:
First Name:RAJESH
Middle Name:C
Last Name:RAMAN
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 1:89 SPARTA AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1777
Mailing Address - Country:US
Mailing Address - Phone:973-726-4455
Mailing Address - Fax:973-726-8445
Practice Address - Street 1:89 SPARTA AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1777
Practice Address - Country:US
Practice Address - Phone:973-726-4455
Practice Address - Fax:973-726-8445
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200150208000000X
NJ25MA08353000208000000X
VA0101239770208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1621897Medicare ID - Type UnspecifiedPROVIDER NUMBER