Provider Demographics
NPI:1649387762
Name:CHILANA, GURMIT S (MD)
Entity Type:Individual
Prefix:
First Name:GURMIT
Middle Name:S
Last Name:CHILANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:25 SHINECOCK TRAIL
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417
Mailing Address - Country:US
Mailing Address - Phone:973-345-9444
Mailing Address - Fax:973-345-6992
Practice Address - Street 1:695 BROADWAY
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514
Practice Address - Country:US
Practice Address - Phone:973-345-9444
Practice Address - Fax:973-345-6992
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA51089207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1110209Medicaid
A56904Medicare UPIN
NJ1110209Medicaid