Healthcare Provider Details

I. General information

NPI: 1487464863
Provider Name (Legal Business Name): AISHA RAUF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 RENAISSANCE BLVD
SOMERSET NJ
08873-6041
US

IV. Provider business mailing address

17 TUDOR DR
SOMERSET NJ
08873-7477
US

V. Phone/Fax

Practice location:
  • Phone: 732-912-8819
  • Fax:
Mailing address:
  • Phone: 732-912-8819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15249500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: