Provider Demographics
NPI:1720107782
Name:KAUR, AMANDEEP (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDEEP
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-4226
Mailing Address - Country:US
Mailing Address - Phone:518-886-5600
Mailing Address - Fax:
Practice Address - Street 1:24 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-4226
Practice Address - Country:US
Practice Address - Phone:518-886-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI66372-20207Q00000X
VA0101267019207Q00000X
NY309608-01207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIK400358589OtherWI MEDICARE
WI1720107782Medicaid
WIKAURAM2OtherMERCYCARE INSURANCE
WI1720107782OtherBCBSWI
WI1720107782OtherBCBSWI