Healthcare Provider Details

I. General information

NPI: 1174585855
Provider Name (Legal Business Name): RANDA MINA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RANDA FAHIM MINA MD

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 COUNTY ROAD 601
BELLE MEAD NJ
08502-3923
US

IV. Provider business mailing address

2087 KLOCKNER RD
HAMILTON NJ
08690-3416
US

V. Phone/Fax

Practice location:
  • Phone: 908-281-1574
  • Fax: 908-281-1575
Mailing address:
  • Phone: 609-587-2300
  • Fax: 609-587-8660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA07656800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: