MEDICARE: DR. AMARJOT SINGH NARULA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	25MA04916000	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	223027400	OTHER	NJ	FED TAX ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	25MA04916000	OTHER	NJ	NEW JERSEY STATE LICENSE

General Provider Information

NPI Number	:	1396708004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMARJOT SINGH NARULA MD

Provider Business Mailing Address
First Line	:	65 N MAPLE AVE
Second Line	:	SUITE 103
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-3233
Country	:	US
Telephone Number	:	201-670-4423
Fax Number	:	201-670-1660

Provider Business Practice Location Address
First Line	:	65 N MAPLE AVE
Second Line	:	SUITE 103
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-3233
Country	:	US
Telephone Number	:	201-670-4423
Fax Number	:	201-670-1660

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	07/13/2007

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