Provider Demographics
NPI:1285086637
Name:PAUL, NAMRATA (MD)
Entity type:Individual
Prefix:
First Name:NAMRATA
Middle Name:
Last Name:PAUL
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 1:176 RIVERWALK WAY
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07014-1731
Mailing Address - Country:US
Mailing Address - Phone:973-653-4882
Mailing Address - Fax:973-754-4007
Practice Address - Street 1:57 WILLOWBROOK BLVD STE 303
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-7047
Practice Address - Country:US
Practice Address - Phone:973-754-4060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD0088084207RE0101X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program