Healthcare Provider Details

I. General information

NPI: 1972417814
Provider Name (Legal Business Name): RISE INTEGRATIVE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 S MAIN ST
MARLBORO NJ
07746-1539
US

IV. Provider business mailing address

9 S MAIN ST
MARLBORO NJ
07746-1539
US

V. Phone/Fax

Practice location:
  • Phone: 609-665-7319
  • Fax:
Mailing address:
  • Phone: 609-665-7319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANMOL KHADTALE
Title or Position: OWNER
Credential: DO
Phone: 609-665-7319