Provider Demographics
NPI:1831538909
Name:VIRK, GURVINDER K (FNP)
Entity type:Individual
Prefix:MRS
First Name:GURVINDER
Middle Name:K
Last Name:VIRK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:GURVINDER
Other - Middle Name:
Other - Last Name:KAUR-SINGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:111 CLOCK TOWER CMNS
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-4055
Mailing Address - Country:US
Mailing Address - Phone:845-264-2611
Mailing Address - Fax:
Practice Address - Street 1:1123 ROUTE 82
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-6206
Practice Address - Country:US
Practice Address - Phone:845-471-3500
Practice Address - Fax:877-546-3181
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04338203Medicaid