Provider Demographics
NPI:1386214203
Name:UPPAL, NAVDEEP (PT)
Entity Type:Individual
Prefix:
First Name:NAVDEEP
Middle Name:
Last Name:UPPAL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WHITE OAK CT
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-2342
Mailing Address - Country:US
Mailing Address - Phone:732-259-3907
Mailing Address - Fax:
Practice Address - Street 1:1501 LIVINGSTON AVE STE 101
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1880
Practice Address - Country:US
Practice Address - Phone:732-325-9234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02003600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist