Healthcare Provider Details

I. General information

NPI: 1669511721
Provider Name (Legal Business Name): RIPLE JAYANTILAL HANSALIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 10/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 STATE ROUTE 33
NEPTUNE NJ
07753-4860
US

IV. Provider business mailing address

1303 CENTRAL AVE
ABERDEEN NJ
07747-1064
US

V. Phone/Fax

Practice location:
  • Phone: 732-776-8500
  • Fax:
Mailing address:
  • Phone: 410-499-2197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0060408
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number231557
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA08572200
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number25MA08572200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: