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General NPI Number Information
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NPI Number | 1952419871
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Entity Type | Organization
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Legal Business Name | GURVINDRA SINGH JOHAL DO PA INC.
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 1813 OAK TREE RD
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City | EDISON
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State | NJ
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Zip | 08820-2740
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Country | US
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Telephone | 908-769-9494
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Fax | 908-755-3833
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Provider Business Mailing Address
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Address Line | 1813 OAK TREE RD
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City | EDISON
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State | NJ
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Zip | 08820-2740
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Country | US
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Telephone | 908-769-9494
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Fax | 908-755-3833
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | BINITA PATEL
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Credential |
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Telephone | 732-290-1014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MAO4637200
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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 | MAO4582200
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 25MBO6533000
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License Number State | NJ
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