Provider Demographics
NPI:1902550114
Name:RAJGANDHI, RAKESH LAXMIKANT
Entity Type:Individual
Prefix:
First Name:RAKESH
Middle Name:LAXMIKANT
Last Name:RAJGANDHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1463 FINNEGAN LN UNIT 11
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-5025
Mailing Address - Country:US
Mailing Address - Phone:732-658-3922
Mailing Address - Fax:732-658-3923
Practice Address - Street 1:1463 FINNEGAN LN UNIT 11
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-5025
Practice Address - Country:US
Practice Address - Phone:732-658-3922
Practice Address - Fax:732-658-3923
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02711300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist