Provider Demographics
NPI:1093211161
Name:KOUL, PRATEEKA (MD)
Entity Type:Individual
Prefix:
First Name:PRATEEKA
Middle Name:
Last Name:KOUL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 HOSPITAL PLZ
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3602
Mailing Address - Country:US
Mailing Address - Phone:203-276-7147
Mailing Address - Fax:203-276-7368
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-3602
Practice Address - Country:US
Practice Address - Phone:570-271-6472
Practice Address - Fax:570-271-5874
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2023-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4798632084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology