Provider Demographics
NPI:1679582456
Name:KUKAR, NARINDER MOHAN (MD)
Entity type:Individual
Prefix:DR
First Name:NARINDER
Middle Name:MOHAN
Last Name:KUKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6HEATHER LANE
Mailing Address - Street 2:
Mailing Address - City:MUTTONTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11753-1302
Mailing Address - Country:US
Mailing Address - Phone:516-938-4965
Mailing Address - Fax:516-938-9446
Practice Address - Street 1:385 SENECA AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-1340
Practice Address - Country:US
Practice Address - Phone:718-497-0060
Practice Address - Fax:718-497-0060
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111361207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY24594POtherHIP
NY0086703OtherAETNA
NY00200115Medicaid
NYKS918OtherOXFORD
NYA400047035Medicare PIN
NYB14807Medicare UPIN