Provider Demographics
NPI:1881695757
Name:DALAL, KARAMBIR SINGH (MD)
Entity type:Individual
Prefix:
First Name:KARAMBIR
Middle Name:SINGH
Last Name:DALAL
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 1:63 LACEY RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-2966
Mailing Address - Country:US
Mailing Address - Phone:732-849-1075
Mailing Address - Fax:732-849-1076
Practice Address - Street 1:63 LACEY RD
Practice Address - Street 2:SUITEF
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-2966
Practice Address - Country:US
Practice Address - Phone:732-849-1075
Practice Address - Fax:732-849-1076
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA065901207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7312806Medicaid
NJ034554S5KMedicare ID - Type Unspecified
NJ7312806Medicaid