Healthcare Provider Details

I. General information

NPI: 1942089545
Provider Name (Legal Business Name): MISS NIMRAT KAUR SANDHU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date: 04/29/2024
Reactivation Date: 08/28/2026

III. Provider practice location address

255 4TH ST
HOBOKEN NJ
07030
US

IV. Provider business mailing address

255 4TH ST
HOBOKEN NJ
07030
US

V. Phone/Fax

Practice location:
  • Phone: 212-998-9800
  • Fax:
Mailing address:
  • Phone: 201-610-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI03171800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: