Provider Demographics
NPI:1316000540
Name:AMIN, PARUL S (MD)
Entity Type:Individual
Prefix:DR
First Name:PARUL
Middle Name:S
Last Name:AMIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 JANELLE BLVD
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-3455
Mailing Address - Country:US
Mailing Address - Phone:973-952-0007
Mailing Address - Fax:201-854-0050
Practice Address - Street 1:557 BROAD ST
Practice Address - Street 2:RM 22
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-2885
Practice Address - Country:US
Practice Address - Phone:973-667-6650
Practice Address - Fax:201-854-0050
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA61747207R00000X
FLME64262207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6867308Medicaid
NJG24003Medicare UPIN
NJ6867308Medicaid