Healthcare Provider Details

I. General information

NPI: 1396733077
Provider Name (Legal Business Name): USHA NIRANJAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RIVERVIEW PLZ FL 2
RED BANK NJ
07701-1864
US

IV. Provider business mailing address

3600 ROUTE 66 FL 3
NEPTUNE NJ
07753-2645
US

V. Phone/Fax

Practice location:
  • Phone: 732-576-8610
  • Fax: 908-813-8342
Mailing address:
  • Phone: 732-807-0877
  • Fax: 201-751-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA05386700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number25MA05386700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: