Individual
JAGDEV KAUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
333 BROADWAY STE 2, AMITYVILLE, NY 11701-2719
(631) 789-2020
Mailing address
333 BROADWAY STE 2, AMITYVILLE, NY 11701-2719
(631) 789-2020
(631) 789-5669
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
541992-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
541992-1
NYS LICENSE
NY
01
—
F343114-1
NYS LICENSE
NY
Enumeration date
05/15/2019
Last updated
05/15/2019
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