Provider Demographics
NPI:1447638291
Name:SIDHU, GUNEET KAUR (OD)
Entity type:Individual
Prefix:DR
First Name:GUNEET
Middle Name:KAUR
Last Name:SIDHU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 124
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:NJ
Mailing Address - Zip Code:08029-0124
Mailing Address - Country:US
Mailing Address - Phone:800-524-0789
Mailing Address - Fax:
Practice Address - Street 1:4141 MORRISH RD
Practice Address - Street 2:
Practice Address - City:SWARTZ CREEK
Practice Address - State:MI
Practice Address - Zip Code:48473
Practice Address - Country:US
Practice Address - Phone:810-630-0399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-13
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004877152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist