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General NPI Number Information
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NPI Number | 1326468307
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Entity Type | Individual
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Provider Name | SUNIL KUKREJA
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Gender | Male
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Dates
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Enumeration Date | 04/17/2014
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Last Update Date | 08/21/2021
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Provider Practice Location Address
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Address Line | 6555 WOODHAVEN BLVD
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City | REGO PARK
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State | NY
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Zip | 11374-5048
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Country | US
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Telephone | 718-255-6615
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Fax |
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Provider Business Mailing Address
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Address Line | 105 FOURTH ST
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City | EDISON
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State | NJ
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Zip | 08837-2653
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Country | US
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Telephone | 318-655-4393
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 25MA10361300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 292135
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 25MA10361300
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 292135
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License Number State | NY
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