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General NPI Number Information
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NPI Number | 1518496843
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Entity Type | Organization
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Legal Business Name | KEITH GURLAND, M.D.
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Dates
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Enumeration Date | 06/09/2017
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Last Update Date | 06/09/2017
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Provider Practice Location Address
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Address Line | 521 BROADWAY
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City | BAYONNE
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State | NJ
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Zip | 07002
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Country | US
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Telephone | 201-339-1266
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Fax | 201-339-0122
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Provider Business Mailing Address
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Address Line | 521 BROADWAY
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City | BAYONNE
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State | NJ
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Zip | 07002
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Country | US
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Telephone | 201-339-1266
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Fax | 201-339-0122
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | KEITH G. GURLAND
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Credential | MD.
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Telephone | 201-339-1266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MA03644300
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License Number State | NJ
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