Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 03644300 | NJ |
NPI | 1013098805 |
---|---|
Provider Name | Dr. Keith G Gurland |
First Address | Bayonne, NJ 07002-3735 |
Second Address | Bayonne, NJ 07002-3735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 03/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
180001825 | RRMC (01) | NJ |
2061201 | (05) | NJ |
519840 | (02) | NJ |