MEDICARE: DR. MARIA J. RAMDIAL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	25MA09002100	NJ

General Provider Information

NPI Number	:	1720241391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA J. RAMDIAL M.D.

Provider Business Mailing Address
First Line	:	1 DIAMOND HILL RD
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-2104
Country	:	US
Telephone Number	:	908-273-4300
Fax Number	:

Provider Business Practice Location Address
First Line	:	899 MOUNTAIN AVE
Second Line	:
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-3455
Country	:	US
Telephone Number	:	908-588-3765
Fax Number	:	973-218-5928

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2008
Last Update Date	:	09/30/2021

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