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General NPI Number Information
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NPI Number | 1518965045
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Entity Type | Individual
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Provider Name | PADMAJA UPADYA M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 01/24/2014
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Provider Practice Location Address
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Address Line | 703 MAIN ST
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City | PATERSON
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State | NJ
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Zip | 07503-2621
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Country | US
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Telephone | 973-754-2323
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Fax | 973-977-9455
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Provider Business Mailing Address
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Address Line | PO BOX 1593
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City | SECAUCUS
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State | NJ
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Zip | 07096-1593
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Country | US
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Telephone | 201-635-1003
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Fax | 201-635-1332
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA75358
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MA07535800
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License Number State | NJ
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