Provider Demographics
NPI:1043762123
Name:KURIAN, XIOMARA (NP)
Entity Type:Individual
Prefix:
First Name:XIOMARA
Middle Name:
Last Name:KURIAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MONTAUK CT
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-6850
Mailing Address - Country:US
Mailing Address - Phone:718-737-6223
Mailing Address - Fax:
Practice Address - Street 1:186 SUFFOLK AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6946
Practice Address - Country:US
Practice Address - Phone:718-737-6223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00956000363LA2200X
NYF307942-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health