Healthcare Provider Details

I. General information

NPI: 1467602367
Provider Name (Legal Business Name): BOBBY J RUPANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2008
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MOUNTAIN CT
HACKETTSTOWN NJ
07840-2300
US

IV. Provider business mailing address

100 MOUNTAIN CT
HACKETTSTOWN NJ
07840-2300
US

V. Phone/Fax

Practice location:
  • Phone: 908-523-3301
  • Fax: 908-523-3303
Mailing address:
  • Phone: 908-852-3301
  • Fax: 908-523-3303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA08284600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number25MA08284600
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number25MA08284600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: