Provider Demographics
NPI:1487625422
Name:RAJARAMAN, RAVINDRAN THIRUNAVU (MD)
Entity type:Individual
Prefix:DR
First Name:RAVINDRAN
Middle Name:THIRUNAVU
Last Name:RAJARAMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:59 AVENUE AT THE CMN
Mailing Address - Street 2:SUITE#105
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4806
Mailing Address - Country:US
Mailing Address - Phone:732-544-8899
Mailing Address - Fax:732-544-9888
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:732-544-9888
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-28
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07526600207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0066613Medicaid
NJ0066613Medicaid
NJI30332Medicare UPIN