Provider Demographics
NPI:1104967488
Name:NEOPANE, PADAM K (MD)
Entity type:Individual
Prefix:
First Name:PADAM
Middle Name:K
Last Name:NEOPANE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5525 RESEARCH PARK DR
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4873
Mailing Address - Country:US
Mailing Address - Phone:973-831-3540
Mailing Address - Fax:973-831-3503
Practice Address - Street 1:90 BERGEN ST STE 300
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2425
Practice Address - Country:US
Practice Address - Phone:973-972-2111
Practice Address - Fax:973-972-2754
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2022-04-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08490600207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0206385Medicaid
NJ157336Medicare PIN