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General NPI Number Information
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NPI Number | 1639497522
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Entity Type | Organization
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Legal Business Name | V.K. PSYCHIATRY PROFESSIONAL ASSOCIATION
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Dates
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Enumeration Date | 05/17/2010
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Last Update Date | 05/17/2010
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Provider Practice Location Address
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Address Line | 200 PERRINE RD STE 206 OLD BRIDGE PROFESSIONAL PLAZA
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City | OLD BRIDGE
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State | NJ
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Zip | 08857-2836
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Country | US
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Telephone | 732-570-7312
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Fax | 732-588-0854
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Provider Business Mailing Address
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Address Line | 66 NATHAN DR
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City | OLD BRIDGE
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State | NJ
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Zip | 08857-2790
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Country | US
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Telephone | 732-570-7312
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Fax | 732-588-0854
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHILPA UPADHYAY
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Credential | MD
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Telephone | 732-570-7312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA08169800
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License Number State | NJ
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