Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | MA44151 | NJ |
NPI | 1427081736 |
---|---|
Provider Name | Dilip Bharucha |
First Address | New York, NY 10087-2581 |
Second Address | East Brunswick, NJ 08816-5827 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 19/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0725005 | (05) | NJ |
A63157 | (02) | NJ |