Provider Demographics
NPI:1902099880
Name:THAKAR, SOJA PADMA (MD)
Entity Type:Individual
Prefix:
First Name:SOJA
Middle Name:PADMA
Last Name:THAKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SOJA
Other - Middle Name:
Other - Last Name:ANUBKUMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:246 HAMBURG TPKE STE 207
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2160
Mailing Address - Country:US
Mailing Address - Phone:973-653-3366
Mailing Address - Fax:973-653-3365
Practice Address - Street 1:246 HAMBURG TPKE STE 207
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2160
Practice Address - Country:US
Practice Address - Phone:973-653-3366
Practice Address - Fax:973-653-3365
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-118120207R00000X
PAMD441797207RN0300X
NJ25MA10977800207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine