Provider Demographics
NPI:1346623097
Name:KAUR, MANPREET (PA-C)
Entity Type:Individual
Prefix:
First Name:MANPREET
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8834 RANSOM ST
Mailing Address - Street 2:FL 1
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2724
Mailing Address - Country:US
Mailing Address - Phone:646-684-6691
Mailing Address - Fax:
Practice Address - Street 1:11808 101ST AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-1254
Practice Address - Country:US
Practice Address - Phone:718-441-0410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018392363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical