Provider Demographics
NPI:1659672970
Name:INTERNAL MEDICINE & GERIATRIC CARE PC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE & GERIATRIC CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:VANIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAMACHANDRA RAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:732-797-2351
Mailing Address - Street 1:42 HUMMINGBIRD CT
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-2511
Mailing Address - Country:US
Mailing Address - Phone:732-797-2351
Mailing Address - Fax:
Practice Address - Street 1:14 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6402
Practice Address - Country:US
Practice Address - Phone:732-244-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-03
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07491200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty