MEDICARE: KULWINDER KAUR JASWAL RN

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	615576	NY

General Provider Information

NPI Number	:	1811338197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KULWINDER KAUR JASWAL RN

Provider Business Mailing Address
First Line	:	3334 77TH ST APT 6H
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-1216
Country	:	US
Telephone Number	:	646-387-3697
Fax Number	:

Provider Business Practice Location Address
First Line	:	3334 77TH ST APT 6H
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-1216
Country	:	US
Telephone Number	:	646-387-3697
Fax Number	:

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

Provider Enumeration Date	:	07/15/2013
Last Update Date	:	07/15/2013

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