Healthcare Provider Details

I. General information

NPI: 1164567608
Provider Name (Legal Business Name): PIROUZ PARANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 12/09/2020
Certification Date: 12/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CAPITAL WAY STE 385
PENNINGTON NJ
08534-2521
US

IV. Provider business mailing address

2 CAPITAL WAY STE 385
PENNINGTON NJ
08534-2521
US

V. Phone/Fax

Practice location:
  • Phone: 609-303-4838
  • Fax: 609-303-4835
Mailing address:
  • Phone: 609-303-4838
  • Fax: 609-303-4835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA07941500
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA07941500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: