Individual
DR. PURUSHOTHAM N SURAPANENI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
27 S FRANKLIN TPKE, RAMSEY, NJ 07446-2550
(201) 818-0960
(201) 825-9537
Mailing address
77 POPLAR DR, PARAMUS, NJ 07652-1357
(201) 818-0960
(201) 825-9537
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA65862
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8517100
—
NJ
Enumeration date
05/08/2006
Last updated
01/17/2013
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