Provider Demographics
NPI:1083663496
Name:KUMAR, CHITRA (MD)
Entity Type:Individual
Prefix:MRS
First Name:CHITRA
Middle Name:
Last Name:KUMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5311 BOULEVARD EAST
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-3539
Mailing Address - Country:US
Mailing Address - Phone:201-864-7172
Mailing Address - Fax:201-864-5599
Practice Address - Street 1:5311 BOULEVARD EAST
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-3539
Practice Address - Country:US
Practice Address - Phone:201-864-7172
Practice Address - Fax:201-864-5599
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA040566207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C56830Medicare UPIN
KU521019Medicare ID - Type Unspecified