Provider Demographics
NPI:1033596101
Name:KUMAR, ABHISHEK (MD)
Entity Type:Individual
Prefix:MR
First Name:ABHISHEK
Middle Name:
Last Name:KUMAR
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 1:115 EILEEN WAY
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-5302
Mailing Address - Country:US
Mailing Address - Phone:516-795-3033
Mailing Address - Fax:516-590-7684
Practice Address - Street 1:1789 SHEEPSHEAD BAY RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2792
Practice Address - Country:US
Practice Address - Phone:855-321-6784
Practice Address - Fax:516-590-7684
Is Sole Proprietor?:No
Enumeration Date:2015-04-28
Last Update Date:2021-04-26
Deactivation Date:2015-10-29
Deactivation Code:
Reactivation Date:2016-09-23
Provider Licenses
StateLicense IDTaxonomies
LA303413207XS0117X
NJ25MA10893600207XS0117X
NY280111207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine