Provider Demographics
NPI:1659929735
Name:ADULT CHOICE NP IN ADULT HEATH PLLC
Entity Type:Organization
Organization Name:ADULT CHOICE NP IN ADULT HEATH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:MS
Authorized Official - First Name:KAMLA
Authorized Official - Middle Name:NIRMALA
Authorized Official - Last Name:GURCHARAN
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:347-495-6364
Mailing Address - Street 1:93-43 215 ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11428
Mailing Address - Country:US
Mailing Address - Phone:347-495-6364
Mailing Address - Fax:
Practice Address - Street 1:21440 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11427
Practice Address - Country:US
Practice Address - Phone:347-495-6364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-31
Last Update Date:2019-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service