Provider Demographics
NPI:1770872004
Name:JOBANPUTRA, AESHA M (MD)
Entity type:Individual
Prefix:DR
First Name:AESHA
Middle Name:M
Last Name:JOBANPUTRA
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 1:125 PATERSON STREET
Mailing Address - Street 2:MEDICAL EDUCATION BUILDING, SUIT 568
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-2545
Mailing Address - Country:US
Mailing Address - Phone:732-235-7840
Mailing Address - Fax:
Practice Address - Street 1:125 PATERSON STREET
Practice Address - Street 2:MEDICAL EDUCATION BUILDING, SUIT 568
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2545
Practice Address - Country:US
Practice Address - Phone:732-235-7840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09654600207R00000X
NJ351078207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine