Healthcare Provider Details

I. General information

NPI: 1033550033
Provider Name (Legal Business Name): GURPREET PHULL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2013
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 MADISON AVE FL 2
MORRISTOWN NJ
07960-7337
US

IV. Provider business mailing address

465 SOUTH ST STE 103
MORRISTOWN NJ
07960-6442
US

V. Phone/Fax

Practice location:
  • Phone: 973-290-7365
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number25MA11361400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: