Bindoo Rughani-‐Shah, M.D., F.A.A.P
has requested his/her medical records to be transferred to the following:
MD4KIDZ PEDIATRIC GROUP, P.A. 34 CORBETT WAY EATONTOWN, N.J. 07724 PHONE: 732.722.2300 FAX: 888.391.8122
DISCLAIMER: By typing your name above, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.
Your prompt response to the above request is appreciated. Thank you.
Eatontown Office: Plainsboro Office: 34 Corbett Way 3 Liberty Street, Suite 1038 Eatontown, N.J. 07724 Plainsboro, N.J. 08536 Phone: 732.722.2300 Phone: 609.632.0600 Fax: 888.391.8122
Plainsboro Office: Liberty Street, Suite 1038 Plainsboro, N.J. 08536 Phone: 609.632.0600 Fax: 888.391.8122
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