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General NPI Number Information
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NPI Number | 1659929735
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Entity Type | Organization
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Legal Business Name | ADULT CHOICE NP IN ADULT HEATH PLLC
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Dates
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Enumeration Date | 08/31/2019
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Last Update Date | 08/31/2019
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Provider Practice Location Address
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Address Line | 21440 HILLSIDE AVE
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City | QUEENS
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State | NY
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Zip | 11427
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Country | US
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Telephone | 347-495-6364
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Fax |
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Provider Business Mailing Address
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Address Line | 93-43 215 ST
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City | QUEENS
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State | NY
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Zip | 11428
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Country | US
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Telephone | 347-495-6364
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Fax |
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Authorized Official
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Title or Position | NP
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Name | MS. KAMLA NIRMALA GURCHARAN
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Credential | NURSE PRACTITIONER
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Telephone | 347-495-6364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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