Healthcare Provider Details

I. General information

NPI: 1912922956
Provider Name (Legal Business Name): ANIL GARG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 E WASHINGTON AVE
WASHINGTON NJ
07882-1819
US

IV. Provider business mailing address

173 E WASHINGTON AVE P.O. BOX 338
WASHINGTON NJ
07882-1819
US

V. Phone/Fax

Practice location:
  • Phone: 908-689-0547
  • Fax: 908-689-0649
Mailing address:
  • Phone: 908-689-0547
  • Fax: 908-689-0649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License NumberMA047352
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: