Provider Demographics
NPI:1750794384
Name:RUPANI KOTWANI, DEEPA (DMD)
Entity type:Individual
Prefix:DR
First Name:DEEPA
Middle Name:
Last Name:RUPANI KOTWANI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MARKET ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07501-1723
Mailing Address - Country:US
Mailing Address - Phone:973-754-4250
Mailing Address - Fax:
Practice Address - Street 1:21 MARKET ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-1723
Practice Address - Country:US
Practice Address - Phone:973-754-4250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program