Healthcare Provider Details

I. General information

NPI: 1477242535
Provider Name (Legal Business Name): RAN BI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date: 12/07/2023
Reactivation Date: 02/25/2025

III. Provider practice location address

1505 W. SHERMAN AVE.
VINELAND NJ
08360
US

IV. Provider business mailing address

1505 W. SHERMAN AVE. BOX 93
VINELAND NJ
08360
US

V. Phone/Fax

Practice location:
  • Phone: 856-641-8662
  • Fax: 856-575-4944
Mailing address:
  • Phone: 856-641-8662
  • Fax: 856-575-4944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number83428
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: