Healthcare Provider Details

I. General information

NPI: 1023639572
Provider Name (Legal Business Name): KUSHKARAN KAUR DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2020
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 OLD COUNTRY RD
PLAINVIEW NY
11803-4914
US

IV. Provider business mailing address

101 SEARING AVE APT 504
MINEOLA NY
11501-2890
US

V. Phone/Fax

Practice location:
  • Phone: 732-281-4583
  • Fax: 404-237-9562
Mailing address:
  • Phone: 732-281-4583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC007107
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD305021
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN007457-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: