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NPI Code Detail

MEDICARE: DR. JASKARAN GREWAL MD

MEDICARE: DR. JASKARAN GREWAL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianA182843CA
2390200000XStudent in an Organized Health Care Education/Training Program
32084P0800XPsychiatry Physician315034-01NY

General Provider Information

NPI Number : 1053808535
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASKARAN GREWAL MD
Provider Business Mailing Address
First Line : 433 RIVER RD APT 1219
Second Line :
City : HIGHLAND PARK
State : NJ
Zip : 08904-1941
Country : US
Telephone Number : 661-645-1278
Fax Number :
Provider Business Practice Location Address
First Line : 385 5TH AVE RM 1106
Second Line :
City : NEW YORK
State : NY
Zip : 10016-3340
Country : US
Telephone Number : 917-391-0076
Fax Number : 917-477-8649
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2018
Last Update Date : 11/27/2023

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