Basic Information
| Provider Information | |||||||||
| NPI: | 1760629919 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAUR | ||||||||
| FirstName: | KANIKA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.B.B.S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1901 1ST AVE | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100297404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124236771 | ||||||||
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| Practice Location | |||||||||
| Address1: | 48 ROUTE 25A STE 105 | ||||||||
| Address2: | |||||||||
| City: | SMITHTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117871447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6313604000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2009 | ||||||||
| LastUpdateDate: | 04/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 278227 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RI0008X | 278227 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hepatology | 207RG0100X | 278227 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.