Provider Demographics
NPI:1487027835
Name:DEEP, BHUPINDER
Entity Type:Individual
Prefix:
First Name:BHUPINDER
Middle Name:
Last Name:DEEP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 WAKEFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-3653
Mailing Address - Country:US
Mailing Address - Phone:914-237-1790
Mailing Address - Fax:
Practice Address - Street 1:115 WAKEFIELD AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-3653
Practice Address - Country:US
Practice Address - Phone:914-237-1790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287821-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse