Provider Demographics
NPI:1457475519
Name:GUJRAL, VARUN BEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:VARUN
Middle Name:BEN
Last Name:GUJRAL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2163 OAK TREE RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1001
Mailing Address - Country:US
Mailing Address - Phone:732-662-3050
Mailing Address - Fax:732-662-3049
Practice Address - Street 1:2163 OAK TREE RD
Practice Address - Street 2:EDISON
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1001
Practice Address - Country:US
Practice Address - Phone:347-992-0085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00289700213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery