Provider Demographics
NPI:1649400029
Name:GAJERA, AYUSH
Entity Type:Individual
Prefix:
First Name:AYUSH
Middle Name:
Last Name:GAJERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 PARSIPPANY RD
Mailing Address - Street 2:APT 68
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-5108
Mailing Address - Country:US
Mailing Address - Phone:201-952-3393
Mailing Address - Fax:
Practice Address - Street 1:217 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-5645
Practice Address - Country:US
Practice Address - Phone:973-325-5691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052476183500000X
NJ28RI02956900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist