Provider Demographics
NPI:1316992118
Name:KAPADIA, BHUPENDRA (MD)
Entity type:Individual
Prefix:
First Name:BHUPENDRA
Middle Name:
Last Name:KAPADIA
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 1:679 MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304
Mailing Address - Country:US
Mailing Address - Phone:201-433-6500
Mailing Address - Fax:201-433-8010
Practice Address - Street 1:679 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3324
Practice Address - Country:US
Practice Address - Phone:201-433-6500
Practice Address - Fax:201-433-8010
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03151300208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1619209Medicaid
NJKA 460458Medicare ID - Type Unspecified
NJ1619209Medicaid