Provider Demographics
NPI:1700063849
Name:DHILLON, VARINDER (MD)
Entity Type:Individual
Prefix:DR
First Name:VARINDER
Middle Name:
Last Name:DHILLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 CLIFTON AVE
Mailing Address - Street 2:PMB # 344
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1453
Mailing Address - Country:US
Mailing Address - Phone:973-748-0087
Mailing Address - Fax:973-748-0067
Practice Address - Street 1:510 43RD ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-2612
Practice Address - Country:US
Practice Address - Phone:973-748-0087
Practice Address - Fax:973-748-0067
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA100411208VP0014X
NJ25MA08548700208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA08548700OtherLICENSE
CAA100411OtherLICENSE