Provider Demographics
NPI:1881657328
Name:BRANOVAN, ZHANNA (MD)
Entity Type:Individual
Prefix:
First Name:ZHANNA
Middle Name:
Last Name:BRANOVAN
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 1:1680 ROUTE 23 STE 310
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-7520
Mailing Address - Country:US
Mailing Address - Phone:973-831-9222
Mailing Address - Fax:973-831-1460
Practice Address - Street 1:1680 ROUTE 23 STE 310
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-7520
Practice Address - Country:US
Practice Address - Phone:973-831-9222
Practice Address - Fax:973-831-1460
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ69612207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7726805Medicaid
NJ7726805Medicaid
NJG98527Medicare UPIN