Provider Demographics
NPI:1013961465
Name:RAJU, RAMESH (MD)
Entity Type:Individual
Prefix:MR
First Name:RAMESH
Middle Name:
Last Name:RAJU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-2102
Mailing Address - Country:US
Mailing Address - Phone:732-855-9006
Mailing Address - Fax:732-326-0095
Practice Address - Street 1:870 GREEN ST
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-2102
Practice Address - Country:US
Practice Address - Phone:732-855-9006
Practice Address - Fax:732-326-0095
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05402600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF69525Medicare UPIN
NJ440344Medicare ID - Type Unspecified