Provider Demographics
NPI:1679516546
Name:RANA, SOHAIL ANJUM (MD)
Entity Type:Individual
Prefix:
First Name:SOHAIL
Middle Name:ANJUM
Last Name:RANA
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 1:301 SPRING GARDEN RD
Mailing Address - Street 2:ANCORA PSYCHIATRIC CENTER
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-2516
Mailing Address - Country:US
Mailing Address - Phone:609-561-1700
Mailing Address - Fax:856-567-7272
Practice Address - Street 1:301 SPRING GARDEN RD
Practice Address - Street 2:ANCORA PSYCHIATRIC CENTER
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-2516
Practice Address - Country:US
Practice Address - Phone:609-561-1700
Practice Address - Fax:609-567-7272
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1914572084P0804X, 2084P0800X
NJ25MA080240002084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ124954C2BOtherPTAN
NJ124954C2BMedicare PIN