Healthcare Provider Details

I. General information

NPI: 1720998669
Provider Name (Legal Business Name): NUVDEEP KAUR DHILLON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W CAMPUS DR
ORANGE CT
06477-3646
US

IV. Provider business mailing address

400 W CAMPUS DR
ORANGE CT
06477-3646
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-6455
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18103
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95041279
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: