Healthcare Provider Details

I. General information

NPI: 1952578643
Provider Name (Legal Business Name): ANTARPREET KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 06/16/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 ASYLUM AVE SUITE 2109A
HARTFORD CT
06105-1770
US

IV. Provider business mailing address

1000 ASYLUM AVENUE SUITE 2109A
HARTFORD CT
06105
US

V. Phone/Fax

Practice location:
  • Phone: 860-714-5058
  • Fax: 860-714-8311
Mailing address:
  • Phone: 860-714-5058
  • Fax: 860-714-8311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number050316
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number050316
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number050316
License Number StateCT
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number050316
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: