Provider Demographics
NPI:1710461157
Name:TRIPATHI, RACHNABEN (CALA)
Entity Type:Individual
Prefix:
First Name:RACHNABEN
Middle Name:
Last Name:TRIPATHI
Suffix:
Gender:F
Credentials:CALA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MAYFAIR CT
Mailing Address - Street 2:
Mailing Address - City:MONROE TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-2052
Mailing Address - Country:US
Mailing Address - Phone:732-336-0835
Mailing Address - Fax:
Practice Address - Street 1:NEW LIFE ADULT DAYCARE
Practice Address - Street 2:727 FRANKLIN BLVD., SUITE 6
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873
Practice Address - Country:US
Practice Address - Phone:732-253-5658
Practice Address - Fax:732-325-0860
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-21
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ-18112261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJNJ-18112OtherMEDICAL DAYCARE LICENSE