MEDICARE: KULDEEP KAUR APN

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	363LA2200X	Adult Health Nurse Practitioner	26NJ14924300	NJ
2	363LP2300X	Primary Care Nurse Practitioner	26NJ14924300	NJ
3	363LG0600X	Gerontology Nurse Practitioner	26NJ14924300	NJ

General Provider Information

NPI Number	:	1538940002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KULDEEP KAUR APN

Provider Business Mailing Address
First Line	:	116 CRYSTAL ST
Second Line	:
City	:	NORTH ARLINGTON
State	:	NJ
Zip	:	07031-5614
Country	:	US
Telephone Number	:	201-380-6047
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 WASHINGTON AVE
Second Line	:
City	:	BELLEVILLE
State	:	NJ
Zip	:	07109-2930
Country	:	US
Telephone Number	:	973-759-4411
Fax Number	:

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

Provider Enumeration Date	:	10/11/2023
Last Update Date	:	07/10/2025

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