Provider Demographics
NPI:1780641514
Name:GUNN, ANGELA LIJOI (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:LIJOI
Last Name:GUNN
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 1:585 CRESTHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-1316
Mailing Address - Country:US
Mailing Address - Phone:201-891-6105
Mailing Address - Fax:
Practice Address - Street 1:1033 ROUTE 46
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2473
Practice Address - Country:US
Practice Address - Phone:973-779-3911
Practice Address - Fax:973-471-2730
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA57783208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics