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General NPI Number Information
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NPI Number | 1972764256
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Entity Type | Individual
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Provider Name | GURDEEP SINGH MATHAROO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/19/2008
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Last Update Date | 07/30/2014
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Provider Practice Location Address
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Address Line | 57 KENT RD
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City | HOWELL
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State | NJ
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Zip | 07731-2452
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Country | US
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Telephone | 732-364-1505
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Fax | 732-364-1509
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Provider Business Mailing Address
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Address Line | 57 KENT RD
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City | HOWELL
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State | NJ
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Zip | 07731-2452
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Country | US
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Telephone | 732-364-1505
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Fax | 732-364-1509
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 25MA09439800
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License Number State | NJ
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