Healthcare Provider Details

I. General information

NPI: 1700303369
Provider Name (Legal Business Name): NESHA RAMPERSAD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2017
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PROSPECT AVE
HACKENSACK NJ
07601-1915
US

IV. Provider business mailing address

94 WESLEY DR
WEST MILFORD NJ
07480-1630
US

V. Phone/Fax

Practice location:
  • Phone: 551-996-2020
  • Fax:
Mailing address:
  • Phone: 973-986-2514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number25MP00446700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: