Provider Demographics
NPI:1427176437
Name:RANZURMAL, MINA (DMD)
Entity type:Individual
Prefix:DR
First Name:MINA
Middle Name:
Last Name:RANZURMAL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 GARDEN ST
Mailing Address - Street 2:APARTMENT #1
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-3932
Mailing Address - Country:US
Mailing Address - Phone:201-563-1705
Mailing Address - Fax:201-795-9008
Practice Address - Street 1:726 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5002
Practice Address - Country:US
Practice Address - Phone:201-963-9000
Practice Address - Fax:201-795-9008
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022803001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice