Provider Demographics
NPI:1740318559
Name:KUKREJA, MEENAKSHI (MD)
Entity type:Individual
Prefix:DR
First Name:MEENAKSHI
Middle Name:
Last Name:KUKREJA
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 1:35-37 PROGRESS ST STE A3
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1179
Mailing Address - Country:US
Mailing Address - Phone:908-510-4137
Mailing Address - Fax:
Practice Address - Street 1:35-37 PROGRESS ST STE A3
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1179
Practice Address - Country:US
Practice Address - Phone:908-510-4137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03869900207Q00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3245608Medicaid
NJC56611Medicare UPIN
NJKU514815Medicare ID - Type Unspecified