Provider Demographics
NPI:1770568834
Name:OZA, RAJEN P (MD)
Entity type:Individual
Prefix:
First Name:RAJEN
Middle Name:P
Last Name:OZA
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 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:
Practice Address - Street 1:1800 MULBERRY ST.
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-6800
Practice Address - Country:US
Practice Address - Phone:570-703-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 056189L207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA002078081OtherHIGHMARK BLUE SHIELD GROUP
PA1540287Medicaid
PA000790785OtherHIGHMARK BC/BS
PA50083353OtherCAPITAL BLUE CROSS
NJ6729703Medicaid
PA0071711350002Medicaid
NJ223558181OtherNJ TAX ID #
PA524394OtherAETNA
PA5732195OtherAETNA GROUP
PA10183495590001OtherMEDICAID GROUP
PA1518851OtherGATEWAY
PA50081639OtherCAPITAL GROUP
PA03269300OtherCAPITAL BLUE CROSS
NJMA 06302800OtherNJ LICENSE #
NJMA 06302800OtherNJ LICENSE #
NJ6729703Medicaid
PA10183495590001OtherMEDICAID GROUP
NJ6729703Medicaid