Provider Demographics
NPI:1245325414
Name:MALKANI, RAJ S (MD)
Entity type:Individual
Prefix:
First Name:RAJ
Middle Name:S
Last Name:MALKANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LEONARD STREET
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1009
Mailing Address - Country:US
Mailing Address - Phone:732-297-9131
Mailing Address - Fax:
Practice Address - Street 1:WILLETS HEALTH CENTER
Practice Address - Street 2:RUTGERS UNIVERSITY, 11 SUYDAM STREET,
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2889
Practice Address - Country:US
Practice Address - Phone:732-932-9805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03867700208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics