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General NPI Number Information
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NPI Number | 1710931498
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Entity Type | Individual
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Provider Name | SUKHJENDER S GORAYA M.D
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 03/26/2018
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Provider Practice Location Address
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Address Line | 606 ROOSEVELT AVE
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City | CARTERET
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State | NJ
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Zip | 07008-2935
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Country | US
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Telephone | 732-541-6521
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 428
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City | CARTERET
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State | NJ
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Zip | 07008-0428
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Country | US
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Telephone | 732-541-6521
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | MA066839
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MA066839
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License Number State | NJ
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