Provider Demographics
NPI:1598979437
Name:MUKHERJEE, RUPA (MD)
Entity Type:Individual
Prefix:
First Name:RUPA
Middle Name:
Last Name:MUKHERJEE
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 1:201 W 77TH ST
Mailing Address - Street 2:APARTMENT 10 F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6606
Mailing Address - Country:US
Mailing Address - Phone:410-913-8469
Mailing Address - Fax:
Practice Address - Street 1:330 BROOKLINE AVENUE, BETH ISRAEL DEACONESS MEDICAL CEN
Practice Address - Street 2:RABB 420
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-667-1272
Practice Address - Fax:617-667-5826
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2481951207RG0100X
MA249101207RG0100X
CTAPPLICATION PENDING207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine