Healthcare Provider Details

I. General information

NPI: 1013248186
Provider Name (Legal Business Name): RAMANDA CORP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2010
Last Update Date: 06/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 KING GEORGE RD STE 205
BASKING RIDGE NJ
07920-2817
US

IV. Provider business mailing address

413 KING GEORGE RD STE 205
BASKING RIDGE NJ
07920-2817
US

V. Phone/Fax

Practice location:
  • Phone: 908-903-1901
  • Fax: 908-903-1902
Mailing address:
  • Phone: 908-903-1901
  • Fax: 908-903-1902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DAVID FISCHER
Title or Position: MANAGING MEMBER
Credential: DC
Phone: 908-903-1901