Provider Demographics
NPI:1730448655
Name:DHUPAR, KAILASH C (PHD)
Entity type:Individual
Prefix:DR
First Name:KAILASH
Middle Name:C
Last Name:DHUPAR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WALNUT ST W
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-3128
Mailing Address - Country:US
Mailing Address - Phone:201-485-8304
Mailing Address - Fax:
Practice Address - Street 1:6 WALNUT ST W
Practice Address - Street 2:
Practice Address - City:MAHWAH
Practice Address - State:NJ
Practice Address - Zip Code:07430-3128
Practice Address - Country:US
Practice Address - Phone:201-485-8304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-12
Last Update Date:2012-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038088183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist