Individual
RAKESHA DATARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
922 MAIN ST, PATERSON, NJ 07503-2602
(201) 398-6721
Mailing address
65 ROOSEVELT AVE, RIDGEFIELD PARK, NJ 07660-1238
(201) 398-6721
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00415400
NJ
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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