Provider Demographics
NPI:1831824671
Name:UPADHYAY, PREJIN
Entity type:Individual
Prefix:DR
First Name:PREJIN
Middle Name:
Last Name:UPADHYAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 FAIR ST
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-1311
Mailing Address - Country:US
Mailing Address - Phone:607-267-5704
Mailing Address - Fax:
Practice Address - Street 1:102 FAIR ST
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-1311
Practice Address - Country:US
Practice Address - Phone:607-267-5704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-17
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program