Provider Demographics
NPI:1821833773
Name:KAUR, GURSIMRAN (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:GURSIMRAN
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 1:2396 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4257
Mailing Address - Country:US
Mailing Address - Phone:631-629-9036
Mailing Address - Fax:
Practice Address - Street 1:11402 15TH AVE STE 1
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-1402
Practice Address - Country:US
Practice Address - Phone:718-762-8741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1064493183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist