Healthcare Provider Details

I. General information

NPI: 1962267104
Provider Name (Legal Business Name): AMRITA KAUR PARMAR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2024
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 S OCEAN AVE
PATCHOGUE NY
11772-3702
US

IV. Provider business mailing address

30 BAYBERRY LN
LEVITTOWN NY
11756-4039
US

V. Phone/Fax

Practice location:
  • Phone: 631-627-8700
  • Fax:
Mailing address:
  • Phone: 516-524-4558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number031423
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: