Provider Demographics
NPI:1053399170
Name:RANA, YEBARNA S (MD)
Entity type:Individual
Prefix:DR
First Name:YEBARNA
Middle Name:S
Last Name:RANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:YEBARNA
Other - Middle Name:S
Other - Last Name:RANA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:660 COMMONS WAY
Mailing Address - Street 2:BLDG I
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6431
Mailing Address - Country:US
Mailing Address - Phone:732-244-1970
Mailing Address - Fax:
Practice Address - Street 1:660 COMMONS WAY
Practice Address - Street 2:BLDG I
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6431
Practice Address - Country:US
Practice Address - Phone:732-244-1970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03686100174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0358606Medicaid
NJ0358606Medicaid
NJ053399Medicare ID - Type Unspecified