Provider Demographics
NPI:1467602367
Name:RUPANI, BOBBY J (MD)
Entity Type:Individual
Prefix:DR
First Name:BOBBY
Middle Name:J
Last Name:RUPANI
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 1:100 MOUNTAIN CT
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2300
Mailing Address - Country:US
Mailing Address - Phone:908-852-3301
Mailing Address - Fax:908-523-3303
Practice Address - Street 1:100 MOUNTAIN CT
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2300
Practice Address - Country:US
Practice Address - Phone:908-523-3301
Practice Address - Fax:908-523-3303
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08284600390200000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program