Basic Information
Provider Information
NPI: 1700131463
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAUL
FirstName: VIREN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.B,, B.S.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1001 W FAYETTE ST STE 400
Address2:  
City: SYRACUSE
State: NY
PostalCode: 132042866
CountryCode: US
TelephoneNumber: 3159373433
FaxNumber: 3159373833
Practice Location
Address1: 739 IRVING AVE STE 200-300
Address2:  
City: SYRACUSE
State: NY
PostalCode: 13210
CountryCode: US
TelephoneNumber: 3154795070
FaxNumber: 3157012525
Other Information
ProviderEnumerationDate: 07/18/2012
LastUpdateDate: 03/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207RP1001X287117NYY193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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