Provider Demographics
NPI:1609316918
Name:MATHARU, JASBIR KAUR (MD)
Entity Type:Individual
Prefix:
First Name:JASBIR
Middle Name:KAUR
Last Name:MATHARU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JASBIR
Other - Middle Name:KAUR
Other - Last Name:MATHARU-DALEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:255 GREENWICH ST RM 520
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-5504
Mailing Address - Country:US
Mailing Address - Phone:212-935-8725
Mailing Address - Fax:
Practice Address - Street 1:255 GREENWICH ST RM 520
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-5504
Practice Address - Country:US
Practice Address - Phone:212-935-8725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC146240208D00000X
NY204753207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice