MEDICARE: DR. NAUREEN NARULA 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	207R00000X	Internal Medicine Physician	300990-01	NY
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	57721	KY
3	390200000X	Student in an Organized Health Care Education/Training Program	244202	ZZ
4	207RP1001X	Pulmonary Disease Physician	57721	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	30099001	OTHER	NY	STATE LICENSE

General Provider Information

NPI Number	:	1396198115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAUREEN NARULA M.D.

Provider Business Mailing Address
First Line	:	500 SEAVIEW AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-3421
Country	:	US
Telephone Number	:	718-226-8168
Fax Number	:

Provider Business Practice Location Address
First Line	:	740 S LIMESTONE STE L304
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40536-3436
Country	:	US
Telephone Number	:	859-323-6494
Fax Number	:	859-257-2573

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

Provider Enumeration Date	:	07/16/2016
Last Update Date	:	06/12/2023

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