Healthcare Provider Details

I. General information

NPI: 1144657560
Provider Name (Legal Business Name): NARINDER PAUL GREWAL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 03/28/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 MINEOLA BLVD STE 401
MINEOLA NY
11501-2555
US

IV. Provider business mailing address

327 BEACH 19TH ST
FAR ROCKAWAY NY
11691-4423
US

V. Phone/Fax

Practice location:
  • Phone: 516-663-1145
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number276635-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: