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General NPI Number Information
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NPI Number | 1568680841
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Entity Type | Organization
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Legal Business Name | MADHURI BEWTRA, M.D., LLC
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 03/04/2011
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Provider Practice Location Address
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Address Line | 405A SOUTH VAN BRUNT ST SUITE 405
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City | ENGLEWOOD
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State | NJ
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Zip | 07646-4604
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Country | US
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Telephone | 201-871-4346
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Fax | 201-871-5953
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Provider Business Mailing Address
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Address Line | 405A SOUTH VAN BRUNT ST SUITE 405
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City | ENGLEWOOD
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State | NJ
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Zip | 07646-4604
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Country | US
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Telephone | 201-871-4346
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Fax | 201-871-5953
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MADHURI BEWTRA
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Credential | M.D.
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Telephone | 201-871-4346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
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License Number | H49244
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License Number State | NJ
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