Provider Demographics
NPI:1245892959
Name:KAUR, PAWANJEET
Entity type:Individual
Prefix:
First Name:PAWANJEET
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 NEWARK POMPTON TPKE
Mailing Address - Street 2:
Mailing Address - City:PEQUANNOCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07440-1327
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:156 NEWARK POMPTON TPKE
Practice Address - Street 2:
Practice Address - City:PEQUANNOCK
Practice Address - State:NJ
Practice Address - Zip Code:07440
Practice Address - Country:US
Practice Address - Phone:973-692-1221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-02
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344085363LF0000X
NJ26NJ00931000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily