Healthcare Provider Details

I. General information

NPI: 1023696713
Provider Name (Legal Business Name): SAVANNA DASGUPTA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PHEASANT DR
LAWRENCEVILLE NJ
08648-5547
US

IV. Provider business mailing address

5 PHEASANT DR
LAWRENCEVILLE NJ
08648-5547
US

V. Phone/Fax

Practice location:
  • Phone: 609-433-8656
  • Fax:
Mailing address:
  • Phone: 609-433-8656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MB12775600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: