Healthcare Provider Details

I. General information

NPI: 1912968728
Provider Name (Legal Business Name): RAJNEESH NATH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RAJNEESH NATH MD

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 04/16/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LITTLE ALBANY STREET, 9TH FLOOR
NEW BRUNSWICK NJ
08901
US

IV. Provider business mailing address

55 LAKE AVE N
WORCESTER MA
01655-0002
US

V. Phone/Fax

Practice location:
  • Phone: 732-235-2465
  • Fax:
Mailing address:
  • Phone: 774-442-3903
  • Fax: 774-443-7890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number237787
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number25MA07376000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: