Provider Demographics
NPI:1821048554
Name:AL KANA, RANDAH (MD)
Entity Type:Individual
Prefix:
First Name:RANDAH
Middle Name:
Last Name:AL KANA
Suffix:
Gender:F
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:PO BOX 95000 CL# 4480
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-4480
Mailing Address - Country:US
Mailing Address - Phone:738-737-0009
Mailing Address - Fax:973-873-7035
Practice Address - Street 1:1515 BROAD ST
Practice Address - Street 2:SUITE 130-B
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3085
Practice Address - Country:US
Practice Address - Phone:973-873-7000
Practice Address - Fax:973-873-7025
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05729200207ZH0000X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0872055000OtherAMERIHEALTH
1073175OtherMHP
NJ6816606Medicaid
NJ6816606Medicaid
1073175OtherMHP