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Individual

DEEPA RAJIV

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
60 EVERGREEN PLACE, SUITE 400, EAST ORANGE, NJ 07018
(973) 395-1550
(973) 395-1556
Mailing address
21 EDGEWOOD ROAD, SUMMIT, NJ 07901
(973) 395-1550
(973) 395-1556

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA08250600
NJ
207R00000X
Internal Medicine Physician
36116763
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036116763
ILLINOIS LICENSE
IL
Enumeration date
08/17/2006
Last updated
09/10/2020
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