Individual provider Active NPI

Gita Dalal, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Edison, NJ
National Provider Identifier
1184649311
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
MAO38240 Issued in NJ
Practice address
16 Ethel Rd
Edison, NJ 08817-2249
Phone
(732) 248-0088
Fax
(732) 248-4405
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X MAO38240 NJ Primary

Addresses

Primary practice location

16 Ethel Rd
Edison, NJ 08817-2249

Mailing address

49 Roxy Ave
Edison, NJ 08820-1641
Phone (732) 574-2796

Other identifiers 1

IdentifierTypeStateIssuer
MAO38240OtherNJLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MAO38240NJMDSports Medicine (Family Medicine) Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184649311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 ROXY AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201641",
            "telephone_number": "732-574-2796",
            "fax_number": "732-574-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 ETHEL RD",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172249",
            "telephone_number": "732-248-0088",
            "fax_number": "732-248-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALAL",
        "first_name": "GITA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NJ",
            "license": "MAO38240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MAO38240",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.