Provider Demographics
NPI:1770556870
Name:NIJJAR, GURKIRPAL S (MD)
Entity type:Individual
Prefix:DR
First Name:GURKIRPAL
Middle Name:S
Last Name:NIJJAR
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 1:2082 ORCHARD PARK DR
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-2237
Mailing Address - Country:US
Mailing Address - Phone:518-382-9116
Mailing Address - Fax:
Practice Address - Street 1:2082 ORCHARD PARK DR
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-2237
Practice Address - Country:US
Practice Address - Phone:518-382-9116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1639782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMMISMedicaid
NYBB1756Medicare PIN
NYMMISMedicaid