Provider Demographics
NPI:1912922956
Name:GARG, ANIL (MD)
Entity Type:Individual
Prefix:
First Name:ANIL
Middle Name:
Last Name:GARG
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 1:173 E WASHINGTON AVE
Mailing Address - Street 2:P.O. BOX 338
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-1819
Mailing Address - Country:US
Mailing Address - Phone:908-689-0547
Mailing Address - Fax:908-689-0649
Practice Address - Street 1:173 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-1819
Practice Address - Country:US
Practice Address - Phone:908-689-0547
Practice Address - Fax:908-689-0649
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA047352207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3767108Medicaid
NJP2043536OtherOXFORD HEALTH
NJ1052196OtherHORIZONNEW JERSEY HEALTH
AL203135OtherUSFHP
NJ1K3464OtherACS/HEALTHNET
AL203135OtherUSFHP
NJ3767108Medicaid