Healthcare Provider Details
I. General information
NPI: 1467297069
Provider Name (Legal Business Name): DR. KAVNEET KAUR PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/26/2024
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
39 WEISS RD
UPPER SADDLE RIVER NJ
07458-1323
US
IV. Provider business mailing address
39 WEISS RD
UPPER SADDLE RIVER NJ
07458-1323
US
V. Phone/Fax
- Phone: 914-374-1750
- Fax:
- Phone: 914-374-1750
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084V0102X |
| Taxonomy | Vascular Neurology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KAVNEET
KAUR
Title or Position: AUTHORIZED OFFICIAL/OWNER
Credential: MD
Phone: 914-610-6916