Provider Demographics
NPI:1740141712
Name:LALLY, KIRANVEER KAUR (RN)
Entity type:Individual
Prefix:
First Name:KIRANVEER
Middle Name:KAUR
Last Name:LALLY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 IRVING ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-2234
Mailing Address - Country:US
Mailing Address - Phone:425-943-0284
Mailing Address - Fax:
Practice Address - Street 1:28-11 QUEENS PLAZA NORTH NY 11101
Practice Address - Street 2:5TH FLOOR
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101
Practice Address - Country:US
Practice Address - Phone:718-391-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN14481163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty