Healthcare Provider Details

I. General information

NPI: 1083351126
Provider Name (Legal Business Name): NAVNEET KAUR BRACAMONTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NAVNEET KAUR ATWAI

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 W END AVE
NEW YORK NY
10023-7839
US

IV. Provider business mailing address

551 6TH AVE
NEW HYDE PARK NY
11040-5455
US

V. Phone/Fax

Practice location:
  • Phone: 212-315-8233
  • Fax: 212-315-8234
Mailing address:
  • Phone: 631-252-2845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number344609
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: