MEDICARE: KULJIT MANN

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	163W00000X	Registered Nurse	729947	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	403135	NY

General Provider Information

NPI Number	:	1366963290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KULJIT MANN

Provider Business Mailing Address
First Line	:	521 5TH AVE STE 1722
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10175-0003
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 E 23RD ST STE 500
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10010-4581
Country	:	US
Telephone Number	:	914-359-3257
Fax Number	:

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

Provider Enumeration Date	:	06/30/2017
Last Update Date	:	05/12/2022

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Directions to “ KULJIT MANN ” Practice Location

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