Provider Demographics
NPI:1801557178
Name:KAUR, SUKHJIT (FNP)
Entity type:Individual
Prefix:MRS
First Name:SUKHJIT
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2248 BROADWAY STE 1329
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5805
Mailing Address - Country:US
Mailing Address - Phone:315-505-2400
Mailing Address - Fax:315-505-2458
Practice Address - Street 1:246 W 80TH ST
Practice Address - Street 2:FL 4 STE 15
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-5705
Practice Address - Country:US
Practice Address - Phone:315-505-2400
Practice Address - Fax:914-505-2458
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF348503-01363LF0000X
NY348503-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07157555Medicaid
NYF348503-01OtherLICENSE