Provider Demographics
NPI:1477761443
Name:LAHIRI, NUPUR (MD)
Entity Type:Individual
Prefix:
First Name:NUPUR
Middle Name:
Last Name:LAHIRI
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 1:4105 US HIGHWAY 1
Mailing Address - Street 2:SUITE 11
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-2157
Mailing Address - Country:US
Mailing Address - Phone:732-355-1158
Mailing Address - Fax:732-355-1157
Practice Address - Street 1:4105 US HIGHWAY 1
Practice Address - Street 2:SUITE 11
Practice Address - City:MONMOUTH JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08852-2157
Practice Address - Country:US
Practice Address - Phone:732-355-1158
Practice Address - Fax:732-355-1157
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA048196207Q00000X, 2084P0005X, 2084P0015X, 2084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered2084P0005XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurodevelopmental Disabilities
Not Answered2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC49788Medicare UPIN
NJ192461Medicare ID - Type Unspecified