Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 25MA59602 | NJ |
NPI | 1033193628 |
---|---|
Provider Name | Mr. Sanjeev Nayyar |
First Address | Wickatunk, NJ 07765-0209 |
Second Address | Old Bridge, NJ 08857-2842 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 28/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F68827 | (02) |