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NPI Code Detail

MEDICARE: MISS NOOPUR BIMAL KOTAK PA-C

MEDICARE: MISS NOOPUR BIMAL KOTAK PA-C
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
1363A00000XPhysician Assistant030936NY

General Provider Information

NPI Number : 1477339281
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS NOOPUR BIMAL KOTAK PA-C
Provider Business Mailing Address
First Line : 1 EMBARCADERO CTR STE 1900
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94111-3723
Country : US
Telephone Number : 888-663-6331
Fax Number :
Provider Business Practice Location Address
First Line : 1065 SOUTHERN BLVD
Second Line :
City : BRONX
State : NY
Zip : 10459-2417
Country : US
Telephone Number : 718-589-2440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2023
Last Update Date : 05/14/2026

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Directions to “ MISS NOOPUR BIMAL KOTAK PA-C” Practice Location

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