Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 25MA10361300 | NJ |
N | 207X00000X | Orthopaedic Surgeon | 292135 | NY |
N | 207XS0117X | Orthopaedic Spine Surgeon | 25MA10361300 | NJ |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 292135 | NY |
NPI | 1326468307 |
---|---|
Provider Name | Sunil Kukreja |
First Address | Edison, NJ 08837-2653 |
Second Address | Rego Park, NY 11374-5048 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2014 |
Last Update Date | 21/08/2021 |