Provider Demographics
NPI:1265401061
Name:RANA, JAGPAL (MD)
Entity type:Individual
Prefix:DR
First Name:JAGPAL
Middle Name:
Last Name:RANA
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 1:906 OAK TREE AVE
Mailing Address - Street 2:SUITE # K-L
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5127
Mailing Address - Country:US
Mailing Address - Phone:908-668-8800
Mailing Address - Fax:908-668-9469
Practice Address - Street 1:906 OAK TREE AVE
Practice Address - Street 2:SUITE # K-L
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5127
Practice Address - Country:US
Practice Address - Phone:908-668-8800
Practice Address - Fax:908-668-9469
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04369300207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0724904Medicaid
NJ0724904Medicaid
NJU PIN # 19632Medicare ID - Type UnspecifiedMEDICARE U PIN NUMBER