Provider Demographics
NPI:1821001272
Name:SALEM, RAJA (MD)
Entity Type:Individual
Prefix:
First Name:RAJA
Middle Name:
Last Name:SALEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3131 PRINCETON PIKE
Mailing Address - Street 2:BLDG 5 SUITE 208
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648
Mailing Address - Country:US
Mailing Address - Phone:609-815-7829
Mailing Address - Fax:609-815-7894
Practice Address - Street 1:40 FULD ST
Practice Address - Street 2:SUITE 303
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638-5247
Practice Address - Country:US
Practice Address - Phone:609-396-2600
Practice Address - Fax:609-396-3600
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2016-11-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06188700208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6625606Medicaid
NJF63701Medicare UPIN
NJ792253N9PMedicare PIN