MEDICARE: DR. NIRMOLRATTAN KAUR CHANDHOKE D.M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	056882	NY

General Provider Information

NPI Number	:	1174956627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIRMOLRATTAN KAUR CHANDHOKE D.M.D

Provider Business Mailing Address
First Line	:	8539 WAREHAM PL
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11432-3047
Country	:	US
Telephone Number	:	718-306-2704
Fax Number	:

Provider Business Practice Location Address
First Line	:	1154 FULTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-2077
Country	:	US
Telephone Number	:	718-306-2704
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2013
Last Update Date	:	08/19/2013

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