Provider Demographics
NPI:1205317609
Name:SIDHU-VALCOURT, ASHMEET KAUR (OD)
Entity type:Individual
Prefix:DR
First Name:ASHMEET
Middle Name:KAUR
Last Name:SIDHU-VALCOURT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ASHMEET
Other - Middle Name:KAUR
Other - Last Name:SIDHU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:60 BROAD ST LBBY A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-2351
Mailing Address - Country:US
Mailing Address - Phone:212-785-0797
Mailing Address - Fax:
Practice Address - Street 1:60 BROAD ST LBBY A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004
Practice Address - Country:US
Practice Address - Phone:212-785-0797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV008861-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist