Provider Demographics
NPI:1164492385
Name:TRIPATHI, NEETA (MD)
Entity Type:Individual
Prefix:
First Name:NEETA
Middle Name:
Last Name:TRIPATHI
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 1:4755 OGLETOWN STANTON RD STE 1070
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718-2200
Mailing Address - Country:US
Mailing Address - Phone:302-733-1663
Mailing Address - Fax:302-733-1616
Practice Address - Street 1:4755 OGLETOWN STANTON RD STE 1070
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:302-733-1663
Practice Address - Fax:302-733-1616
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06877000207RC0000X
DEC1-0026310207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8172901Medicaid
NJ22-3052989OtherTAX ID
NJ22-3052989OtherTAX ID
G91705Medicare UPIN