Provider Demographics
NPI:1578084398
Name:GUR, JYOTI
Entity Type:Individual
Prefix:
First Name:JYOTI
Middle Name:
Last Name:GUR
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 1:4341 44TH ST APT 2F
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-4613
Mailing Address - Country:US
Mailing Address - Phone:781-975-9519
Mailing Address - Fax:
Practice Address - Street 1:4341 44TH ST APT 2F
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-4613
Practice Address - Country:US
Practice Address - Phone:781-975-9519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program