Healthcare Provider Details

I. General information

NPI: 1477258614
Provider Name (Legal Business Name): RAHUL SHAILESH TRIPATHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 PLAINFIELD AVE
EDISON NJ
08817-3713
US

IV. Provider business mailing address

161 PLAINFIELD AVE
EDISON NJ
08817-3713
US

V. Phone/Fax

Practice location:
  • Phone: 908-425-5763
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: