Provider Demographics
NPI:1497081475
Name:KAUR, HARMINDER
Entity Type:Individual
Prefix:
First Name:HARMINDER
Middle Name:
Last Name:KAUR
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 1:72-11-31ST AVENUE
Mailing Address - Street 2:
Mailing Address - City:EAST-ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370
Mailing Address - Country:US
Mailing Address - Phone:646-920-3403
Mailing Address - Fax:
Practice Address - Street 1:786 MONTAUK HIGHWAY
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795
Practice Address - Country:US
Practice Address - Phone:631-376-6075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013648363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant