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General NPI Number Information
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NPI Number | 1811982499
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Entity Type | Individual
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Provider Name | RAKESH K BANSIL MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 15 YALE CT
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City | LIVINGSTON
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State | NJ
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Zip | 07039-1519
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Country | US
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Telephone | 973-740-0091
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Fax | 973-533-0710
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Provider Business Mailing Address
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Address Line | 15 YALE CT
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City | LIVINGSTON
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State | NJ
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Zip | 07039-1519
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Country | US
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Telephone | 973-740-0091
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Fax | 973-533-0710
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA04247600
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License Number State | NJ
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