Provider Demographics
NPI:1790745180
Name:BOORUJY, DEAN PAUL (DO)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:PAUL
Last Name:BOORUJY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:65 E NORTHFIELD RD
Mailing Address - Street 2:UNIT H
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4231
Mailing Address - Country:US
Mailing Address - Phone:973-422-9595
Mailing Address - Fax:973-422-9390
Practice Address - Street 1:75 E NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4532
Practice Address - Country:US
Practice Address - Phone:973-436-1465
Practice Address - Fax:973-422-9390
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB06228000207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG37963Medicare UPIN
NJ893753Medicare PIN