Provider Demographics
NPI:1164718300
Name:MUKHERJEE, ANGELA (DO)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:MUKHERJEE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 OVERLOOK RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-3570
Mailing Address - Country:US
Mailing Address - Phone:908-273-1112
Mailing Address - Fax:908-273-1146
Practice Address - Street 1:33 OVERLOOK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3570
Practice Address - Country:US
Practice Address - Phone:908-273-1112
Practice Address - Fax:908-273-1146
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08929500208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics