Healthcare Provider Details

I. General information

NPI: 1700483393
Provider Name (Legal Business Name): JASNIR KAUR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2020
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 SLOAN DR S
VALLEY STREAM NY
11580-3218
US

IV. Provider business mailing address

11 SLOAN DR S
VALLEY STREAM NY
11580-3218
US

V. Phone/Fax

Practice location:
  • Phone: 516-884-0146
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number309825
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: