Provider Demographics
NPI:1124074091
Name:KANTHAN, RAJESWARI (MD)
Entity type:Individual
Prefix:DR
First Name:RAJESWARI
Middle Name:
Last Name:KANTHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 S BLACK HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-1900
Mailing Address - Country:US
Mailing Address - Phone:856-629-9000
Mailing Address - Fax:856-629-6440
Practice Address - Street 1:925 S BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094-1900
Practice Address - Country:US
Practice Address - Phone:856-629-9000
Practice Address - Fax:856-629-6440
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05934000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics