Provider Demographics
NPI:1194042317
Name:JUTHANI, RUPA GOPALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RUPA
Middle Name:GOPALAN
Last Name:JUTHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RUPA
Other - Middle Name:
Other - Last Name:GOPALAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1200 E RIDGEWOOD AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450
Mailing Address - Country:US
Mailing Address - Phone:201-327-8600
Mailing Address - Fax:201-327-8225
Practice Address - Street 1:NEUROSURGICAL ASSOCIATES OF NEW JERSEY, P.C.
Practice Address - Street 2:1200 E RIDGEWOOD AVENUE STE 200
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450
Practice Address - Country:US
Practice Address - Phone:201-327-8600
Practice Address - Fax:201-327-8225
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY289606207T00000X
NJ25MA11504900207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty