Provider Demographics
NPI:1811982499
Name:BANSIL, RAKESH K (MD)
Entity type:Individual
Prefix:DR
First Name:RAKESH
Middle Name:K
Last Name:BANSIL
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 1:15 YALE CT
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1519
Mailing Address - Country:US
Mailing Address - Phone:973-740-0091
Mailing Address - Fax:973-533-0710
Practice Address - Street 1:15 YALE CT
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1519
Practice Address - Country:US
Practice Address - Phone:973-740-0091
Practice Address - Fax:973-533-0710
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA042476002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1148401Medicaid
NJ450271Medicare ID - Type Unspecified
NJ1148401Medicaid