Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 25MB08394700 | NJ |
NPI | 1003082660 |
---|---|
Provider Name | Dr. Sukrut Dwivedi |
First Address | Hillsborough, NJ 08844-1528 |
Second Address | Oakhurst, NJ 07755-2715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2008 |
Last Update Date | 06/05/2015 |