Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MA71305 | NJ |
Y | 208600000X | Surgeon | MA71305 | NJ |
N | 2082S0105X | Plastic Hand Surgeon | MA71305 | NJ |
NPI | 1114924487 |
---|---|
Provider Name | Bhupesh Vasisht |
First Address | Voorhees, NJ 08043-2176 |
Second Address | Voorhees, NJ 08043-2176 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2005 |
Last Update Date | 30/01/2008 |