Healthcare Provider Details

I. General information

NPI: 1710514096
Provider Name (Legal Business Name): PARUL JANDIR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 RIVER RD
NORTH BERGEN NJ
07047-6217
US

IV. Provider business mailing address

826 TIMBER RIDGE CT
NEPTUNE NJ
07753-3025
US

V. Phone/Fax

Practice location:
  • Phone: 201-854-5000
  • Fax:
Mailing address:
  • Phone: 408-824-0461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number25MA11798800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA11798800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: