Provider Demographics
NPI:1922695550
Name:KAUR, JASWANT (OD)
Entity Type:Individual
Prefix:DR
First Name:JASWANT
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 PERCHERON LN
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2817
Mailing Address - Country:US
Mailing Address - Phone:516-701-7037
Mailing Address - Fax:
Practice Address - Street 1:881 BROADWAY MALL
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-2712
Practice Address - Country:US
Practice Address - Phone:516-938-6006
Practice Address - Fax:516-513-0156
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009298152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist