Provider Demographics
NPI:1285049171
Name:RAHEJA, HITESH
Entity type:Individual
Prefix:
First Name:HITESH
Middle Name:
Last Name:RAHEJA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 PASSAIC ST
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-5803
Mailing Address - Country:US
Mailing Address - Phone:973-916-0002
Mailing Address - Fax:973-916-0027
Practice Address - Street 1:293 PASSAIC ST
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-5803
Practice Address - Country:US
Practice Address - Phone:973-916-0002
Practice Address - Fax:973-916-0027
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-30
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.131017207R00000X
NY301042-01207R00000X
PAMD472047207RC0000X
NJ25MA11505600207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA11505600OtherSTATE LICENSE