Miyasari Ranoewidjojo, PA C

NPI #1033324645 in Hackensack, New Jersey

Provider Information

NPI Number: 1033324645
Entity Type: Individual
Name: Miyasari Ranoewidjojo, PA C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA C
Enumeration Date: May 14, 2007
Last Updated: Dec 13, 2007

Practice Location

Address: 30 PROSPECT AVE
Address 2: HACKENSACK UNIVERSITY MEDICAL CENTER
City: Hackensack
State: New Jersey
ZIP Code: 07601-1914
Phone: (201) 996-4614

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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