Healthcare Provider Details

I. General information

NPI: 1013365931
Provider Name (Legal Business Name): BADAL D RANA D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 06/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 CHAPEL AVE W
CHERRY HILL NJ
08002-2051
US

IV. Provider business mailing address

2250 CHAPEL AVE W
CHERRY HILL NJ
08002-2051
US

V. Phone/Fax

Practice location:
  • Phone: 856-482-9000
  • Fax:
Mailing address:
  • Phone: 856-482-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number104352
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: