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General NPI Number Information
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NPI Number | 1043311145
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Entity Type | Individual
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Provider Name | DOV JOHANAN RAND M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 2035 HAMBURG TPKE SUITE G
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City | WAYNE
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State | NJ
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Zip | 07470-6251
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Country | US
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Telephone | 973-831-2828
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Fax | 973-831-2829
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Provider Business Mailing Address
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Address Line | PO BOX 2403
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City | WAYNE
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State | NJ
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Zip | 07474-2403
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Country | US
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Telephone | 973-831-2828
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Fax | 973-831-2829
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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