Provider Demographics
NPI:1316108368
Name:RAJARAMAN MEDICINE & PEDIATRICS, LLC
Entity type:Organization
Organization Name:RAJARAMAN MEDICINE & PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVINDRAN
Authorized Official - Middle Name:THIRUNAVU
Authorized Official - Last Name:RAJARAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-544-8899
Mailing Address - Street 1:215 NOTTINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-9518
Mailing Address - Country:US
Mailing Address - Phone:732-591-1294
Mailing Address - Fax:
Practice Address - Street 1:59 AVENUE AT THE CMN
Practice Address - Street 2:SUITE#105
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4806
Practice Address - Country:US
Practice Address - Phone:732-544-8899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07526600261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ091285W7OtherMEDICARE PERSONAL
NJ0066613Medicaid
NJ091285W7OtherMEDICARE PERSONAL