Individual
KISHORE KUPPASANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
185 S ORANGE AVE, UH, H-346, NEWARK, NJ 07103-2757
(973) 972-5283
Mailing address
38 PARK ST, UNIT-4E, FLORHAM PARK, NJ 07932-1794
(973) 966-1655
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00184900
NJ
Other
Enumeration date
10/01/2007
Last updated
10/01/2007
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