Provider Demographics
NPI:1922257252
Name:RATNATHICAM, ANJALI (DO)
Entity Type:Individual
Prefix:DR
First Name:ANJALI
Middle Name:
Last Name:RATNATHICAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:211 ESSEX ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-3231
Mailing Address - Country:US
Mailing Address - Phone:201-487-8882
Mailing Address - Fax:201-487-0943
Practice Address - Street 1:211 ESSEX ST
Practice Address - Street 2:SUITE 102
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-3231
Practice Address - Country:US
Practice Address - Phone:201-487-8882
Practice Address - Fax:201-487-0943
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2013-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2562662086S0129X
NJ25MB08446100208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery