Provider Demographics
NPI:1821311762
Name:KAUR, PRABHJOT (PHARMD)
Entity Type:Individual
Prefix:
First Name:PRABHJOT
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8328 268TH ST
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1749
Mailing Address - Country:US
Mailing Address - Phone:718-559-9366
Mailing Address - Fax:
Practice Address - Street 1:89 HENRY ST
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3906
Practice Address - Country:US
Practice Address - Phone:516-623-9719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-07
Last Update Date:2010-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist