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General NPI Number Information
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NPI Number | 1760928014
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Entity Type | Organization
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Legal Business Name | BHARATI D PENUPATRUNI MD LLC
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 4 DRINKING BROOK RD
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City | MONMOUTH JCT
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State | NJ
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Zip | 08852-2800
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Country | US
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Telephone | 908-307-5695
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Fax |
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Provider Business Mailing Address
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Address Line | 4 DRINKING BROOK RD
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City | MONMOUTH JCT
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State | NJ
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Zip | 08852-2800
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BHARATI D PENUPATRUNI
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Credential |
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Telephone | 908-307-5695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 25MA05220800
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License Number State | NJ
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