Healthcare Provider Details

I. General information

NPI: 1386148773
Provider Name (Legal Business Name): GINA LYNN CARROLL RANIERI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 BUNN DR STE 202
PRINCETON NJ
08540-1968
US

IV. Provider business mailing address

800 BUNN DR STE 202
PRINCETON NJ
08540-1968
US

V. Phone/Fax

Practice location:
  • Phone: 609-430-1900
  • Fax: 609-430-1901
Mailing address:
  • Phone: 609-430-1900
  • Fax: 609-430-1901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number25MB12280200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: