Individual
RAFAEL ENUKASHVILI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21 KILMER DRIVE, BLDG 2 SUITE C, MORGANVILLE, NJ 07751-1568
(732) 617-2988
(732) 617-2987
Mailing address
21 KILMER DRIVE, BLDG 2 SUITE C, MORGANVILLE, NJ 07751-1568
(732) 617-2988
(732) 617-2987
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA064386
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017306
AETNA
NJ
05
—
8651108
—
NJ
01
—
P1123503
OXFORD
NJ
Enumeration date
06/10/2006
Last updated
11/02/2007
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