Provider Demographics
NPI:1477961670
Name:RUPA M. KHETARPAL, LLC
Entity Type:Organization
Organization Name:RUPA M. KHETARPAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUPA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KHETARPAL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:908-294-4391
Mailing Address - Street 1:24 BERKELEY CIR
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-2010
Mailing Address - Country:US
Mailing Address - Phone:908-294-4391
Mailing Address - Fax:
Practice Address - Street 1:66 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5250
Practice Address - Country:US
Practice Address - Phone:908-294-4391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055044001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty