Provider Demographics
NPI:1992776827
Name:BABBAR, PUNEET (MD)
Entity type:Individual
Prefix:
First Name:PUNEET
Middle Name:
Last Name:BABBAR
Suffix:
Gender:F
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:PO BOX 740021
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-0021
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:
Practice Address - Street 1:394 BROADWAY STE 100
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-1932
Practice Address - Country:US
Practice Address - Phone:973-572-1035
Practice Address - Fax:973-547-7872
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07125100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0292303Medicaid
NJ047027Medicare ID - Type Unspecified
NJ0292303Medicaid