Basic Information
| Provider Information | |||||||||
| NPI: | 1407856792 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GREWAL | ||||||||
| FirstName: | RAJI | ||||||||
| MiddleName: | P. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1225 WHITEHORSE MERCERVILLE RD | ||||||||
| Address2: | BUILDING D, SUITE 203 | ||||||||
| City: | HAMILTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086193882 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095816060 | ||||||||
| FaxNumber: | 6095819561 | ||||||||
| Practice Location | |||||||||
| Address1: | 1225 WHITEHORSE MERCERVILLE RD | ||||||||
| Address2: | BUILDING D, SUITE 203 | ||||||||
| City: | HAMILTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086193882 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095816060 | ||||||||
| FaxNumber: | 6095819561 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2005 | ||||||||
| LastUpdateDate: | 06/19/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 25MA06914600 | NJ | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 218610200 | 01 | NJ | AMERIHEALTH | OTHER | P0097929 | 01 | RAILROAD MEDICARE | OTHER | P1730536 | 01 | OXFORD HEALTH PLANS | OTHER | 8215502 | 05 | NJ | MEDICAID | 1739289 | 01 | UNITED HEALTHCARE COMMERCIAL AND MEDICARE | OTHER | 21861020 | 01 | KEYSTONE HEALTH PLAN EAST PCP | OTHER | 261649038 | 01 | NJ | HORIZON BCBS | OTHER | 2240147 | 01 | CIGNA | OTHER | 60067907 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 9102349 | 01 | AETNA PPO | OTHER |