Healthcare Provider Details

I. General information

NPI: 1518262229
Provider Name (Legal Business Name): VANDAN CAUR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2011
Last Update Date: 01/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 YORK AVE DEPARTMENT OF RADIOLOGY
NEW YORK NY
10065-6007
US

IV. Provider business mailing address

303 E 60TH ST APT 36G
NEW YORK NY
10022-1514
US

V. Phone/Fax

Practice location:
  • Phone: 212-646-2000
  • Fax:
Mailing address:
  • Phone: 917-972-6645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberP76396
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: