Individual
TARUN GANGULY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3458 NEELY RD, JOINT BASE MDL, NJ 08641-5312
(609) 754-9414
Mailing address
3458 NEELY RD, JB MDL, NJ 08641-5312
(609) 754-9014
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MB65193
NJ
207Q00000X
Family Medicine Physician
Primary
25
NJ
207R00000X
Internal Medicine Physician
MB65193
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8197105
—
NJ
Enumeration date
07/02/2006
Last updated
01/12/2022
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