Provider Demographics
NPI:1932490687
Name:AUJLA, PARDEEP (MD)
Entity Type:Individual
Prefix:
First Name:PARDEEP
Middle Name:
Last Name:AUJLA
Suffix:
Gender:F
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:PO BOX 808
Mailing Address - Street 2:SJ PHYSICIAN SERVICES
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03061-0808
Mailing Address - Country:US
Mailing Address - Phone:603-595-2997
Mailing Address - Fax:
Practice Address - Street 1:1595 BRIDGE ST UNIT 3
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-2771
Practice Address - Country:US
Practice Address - Phone:978-323-2808
Practice Address - Fax:978-323-2810
Is Sole Proprietor?:No
Enumeration Date:2011-04-29
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH16438207Q00000X
390200000X
MA257360207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program