Provider Demographics
NPI:1124098678
Name:UTHAPPA, MACHIA (MD)
Entity type:Individual
Prefix:
First Name:MACHIA
Middle Name:
Last Name:UTHAPPA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 NEWMAN SPRINGS ROAD
Mailing Address - Street 2:BLDG. 2, SUITE 220
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701
Mailing Address - Country:US
Mailing Address - Phone:732-807-0877
Mailing Address - Fax:201-751-1680
Practice Address - Street 1:1 ETHEL RD
Practice Address - Street 2:SUITE 107B
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-2838
Practice Address - Country:US
Practice Address - Phone:732-287-2020
Practice Address - Fax:732-287-2071
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA061302207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1184722431OtherGROUP NPI NUMBER
NJ7894406Medicaid
NJ7894406Medicaid
G27904Medicare UPIN