Provider Demographics
NPI:1033150776
Name:PENUPATRUNI, BHARATI (MD)
Entity Type:Individual
Prefix:DR
First Name:BHARATI
Middle Name:
Last Name:PENUPATRUNI
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 1:666 PLAINSBORO RD
Mailing Address - Street 2:SUITE 1005
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-3030
Mailing Address - Country:US
Mailing Address - Phone:609-799-3119
Mailing Address - Fax:732-274-0773
Practice Address - Street 1:666 PLAINSBORO RD
Practice Address - Street 2:SUITE 1005
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-3030
Practice Address - Country:US
Practice Address - Phone:609-799-3119
Practice Address - Fax:732-274-0773
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05220800208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6404308Medicaid
NJF95422Medicare UPIN
NJ6404308Medicaid