Provider Demographics
NPI:1962097196
Name:KAUR, IQNOOR DEEP
Entity type:Individual
Prefix:
First Name:IQNOOR
Middle Name:DEEP
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 1:187 MARCUS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3428
Mailing Address - Country:US
Mailing Address - Phone:516-450-7682
Mailing Address - Fax:
Practice Address - Street 1:200 FOREST DR
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-2320
Practice Address - Country:US
Practice Address - Phone:516-776-0386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker