Provider Demographics
NPI:1881662062
Name:GARG, VIPIN (MD)
Entity type:Individual
Prefix:DR
First Name:VIPIN
Middle Name:
Last Name:GARG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:240 WILLIAMSON ST
Mailing Address - Street 2:SUITE NUMBER 300
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-3674
Mailing Address - Country:US
Mailing Address - Phone:908-994-8880
Mailing Address - Fax:908-360-0490
Practice Address - Street 1:240 WILLIAMSON ST
Practice Address - Street 2:SUITE NUMBER 300
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-3674
Practice Address - Country:US
Practice Address - Phone:908-994-8880
Practice Address - Fax:908-360-0490
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA70132207RP1001X, 207RC0200X, 207RS0012X
NJ25MA07013200207R00000X
NY220328207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9122303Medicaid
H28278Medicare UPIN
NY862231Medicare PIN
NJ069307Medicare PIN