Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 25MA11361400 | NJ |
NPI | 1033550033 |
---|---|
Provider Name | Gurpreet Phull |
First Address | Hackensack, NJ 07601-1915 |
Second Address | Hackensack, NJ 07601-1915 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2013 |
Last Update Date | 26/01/2022 |