Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | MA066839 | NJ |
Y | 207R00000X | Internist | MA066839 | NJ |
Y | 111NI0900X | Internist | MA066839 | NJ |
NPI | 1710931498 |
---|---|
Provider Name | Dr. Sukhjender S Goraya |
First Address | Carteret, NJ 07008-0428 |
Second Address | Carteret, NJ 07008-2935 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 26/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G67524 | (02) |