Basic Information
Provider Information
NPI: 1902213879
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RANJITKAR
FirstName: PARAS
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 117 ELLENFIELD ST STE 101
Address2:  
City: PROVIDENCE
State: RI
PostalCode: 029054513
CountryCode: US
TelephoneNumber: 4014446779
FaxNumber: 4014446912
Practice Location
Address1: 123 SUMMER ST
Address2:  
City: WORCESTER
State: MA
PostalCode: 01608
CountryCode: US
TelephoneNumber: 5083636208
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/12/2014
LastUpdateDate: 08/01/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X260470MAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XMD15776RIY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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