Provider Demographics
NPI:1497638514
Name:KAUR, RAJDEEP
Entity type:Individual
Prefix:
First Name:RAJDEEP
Middle Name:
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 1:4300 BEECH DR
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-8627
Mailing Address - Country:US
Mailing Address - Phone:646-764-6478
Mailing Address - Fax:
Practice Address - Street 1:325 N BROADWAY
Practice Address - Street 2:
Practice Address - City:WIND GAP
Practice Address - State:PA
Practice Address - Zip Code:18091-1214
Practice Address - Country:US
Practice Address - Phone:732-375-1661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
PAPT033446363A00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant