Healthcare Provider Details

I. General information

NPI: 1437259751
Provider Name (Legal Business Name): ANIL KAPOOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 01/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 SKYLINE DRIVE
RINGWOOD NJ
07456
US

IV. Provider business mailing address

60 SKYLINE DRIVE
RINGWOOD NJ
07456
US

V. Phone/Fax

Practice location:
  • Phone: 973-962-6661
  • Fax: 973-962-1958
Mailing address:
  • Phone: 973-962-6661
  • Fax: 973-962-1958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMA47149
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: