Individual
JEETINDER K GUJRAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 EAST MAIN STREET, BAYSHORE, NY 11706
(631) 968-3000
Mailing address
301 EAST MAIN STREET, BAYSHORE, NY 11706
(631) 968-3000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
225798
NY
208M00000X
Hospitalist Physician
Primary
225798
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02544672
—
NY
Enumeration date
01/30/2007
Last updated
07/12/2017
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