Healthcare Provider Details

I. General information

NPI: 1629164918
Provider Name (Legal Business Name): JANAH AJI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 02/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CENTENNIAL BLVD BUILDING 2 SUITE 202
VOORHEES NJ
08043-4637
US

IV. Provider business mailing address

1 FEDERAL ST # 100
CAMDEN NJ
08103-1088
US

V. Phone/Fax

Practice location:
  • Phone: 856-325-6700
  • Fax: 856-325-6702
Mailing address:
  • Phone: 856-356-4924
  • Fax: 856-356-4793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD072350L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMA47669
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: