Provider Demographics
NPI:1215905070
Name:UPPAL, PARVEEN (MD)
Entity type:Individual
Prefix:DR
First Name:PARVEEN
Middle Name:
Last Name:UPPAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 HAZLET AVE
Mailing Address - Street 2:STE# 3
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1623
Mailing Address - Country:US
Mailing Address - Phone:732-888-7901
Mailing Address - Fax:732-888-7905
Practice Address - Street 1:80 HAZLET AVE
Practice Address - Street 2:STE# 3
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1623
Practice Address - Country:US
Practice Address - Phone:732-888-7901
Practice Address - Fax:732-888-7905
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06355400207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6954707Medicaid
NJF12062Medicare UPIN
NJ769976RJFMedicare ID - Type Unspecified