Individual
BRIAN PETER VANGROUW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
28-04 BROADWAY, FAIR LAWN, NJ 07410-3920
(201) 791-4434
(201) 791-3423
Mailing address
28-04 BROADWAY, FAIR LAWN, NJ 07410-3920
(201) 791-4434
(201) 791-3423
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MB055905
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0500620001
NHIC, CORP.
—
01
—
200025963
RAILROAD MEDICARE
NJ
05
—
2856204
—
NJ
01
—
5936044
AETNA PPO
NJ
01
—
P558962
OXFORD
NJ
Enumeration date
04/01/2006
Last updated
03/09/2021
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