Individual
BHOOMI UPADHYAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2 MEDICAL PARK DR STE 16, WEST NYACK, NY 10994-1966
(845) 535-3500
Mailing address
41 BYRON PL, CLIFTON, NJ 07011-3809
(973) 513-2830
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
059201-1
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2016
Last updated
11/15/2017
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