Healthcare Provider Details

I. General information

NPI: 1174104558
Provider Name (Legal Business Name): VARUN PANDYA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2021
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 NJ-33
NEPTUNE CITY NJ
07753
US

IV. Provider business mailing address

331 NEWMAN SPRINGS ROAD BLDG. 2, SUITE 220
RED BANK NJ
07701
US

V. Phone/Fax

Practice location:
  • Phone: 732-897-3600
  • Fax: 732-897-3660
Mailing address:
  • Phone: 732-807-0877
  • Fax: 201-751-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA13114500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: