Provider Demographics
NPI:1417926429
Name:GURON, GUNWANT (MD)
Entity Type:Individual
Prefix:DR
First Name:GUNWANT
Middle Name:
Last Name:GURON
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:PO BOX 706
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-0706
Mailing Address - Country:US
Mailing Address - Phone:973-877-5434
Mailing Address - Fax:
Practice Address - Street 1:268 DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-2011
Practice Address - Country:US
Practice Address - Phone:973-877-5434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA59592207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6029302Medicaid
NJ6029302Medicaid
NJF73198Medicare UPIN