Provider Demographics
NPI:1154382372
Name:RANA, ANIL (PT)
Entity type:Individual
Prefix:DR
First Name:ANIL
Middle Name:
Last Name:RANA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 BLOOMFIELD AVENUE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006
Mailing Address - Country:US
Mailing Address - Phone:973-439-1007
Mailing Address - Fax:973-439-1009
Practice Address - Street 1:1140 BLOOMFIELD AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006
Practice Address - Country:US
Practice Address - Phone:973-439-1007
Practice Address - Fax:973-439-1009
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00975800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q23415Medicare UPIN
NJ083012TYFMedicare ID - Type Unspecified