Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | MA028787 | NJ |
NPI | 1013019884 |
---|---|
Provider Name | Mr. Rameshchandra S Ghanekar |
First Address | Iselin, NJ 08830 |
Second Address | Iselin, NJ 08830 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D36141 | (02) |