Healthcare Provider Details

I. General information

NPI: 1225944044
Provider Name (Legal Business Name): KEN HANSRAJ MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 KINDERKAMACK RD STE 305
ORADELL NJ
07649-1600
US

IV. Provider business mailing address

PO BOX 247
CONGERS NY
10920-0247
US

V. Phone/Fax

Practice location:
  • Phone: 551-386-7300
  • Fax: 551-355-5097
Mailing address:
  • Phone: 551-386-7300
  • Fax: 845-268-5519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARCIA GRIFFIN-HANSRAJ
Title or Position: OWNER
Credential: DO
Phone: 914-672-0170