Healthcare Provider Details

I. General information

NPI: 1720303316
Provider Name (Legal Business Name): SKYLANDS VASCULAR SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 US HIGHWAY 206 STE C
STANHOPE NJ
07874-3270
US

IV. Provider business mailing address

16 US HIGHWAY 206 STE C
STANHOPE NJ
07874-3270
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number25MA08284600
License Number StateNJ

VIII. Authorized Official

Name: BOBBY RUPANI
Title or Position: DOCTOR
Credential:
Phone: 908-852-3301