Provider Demographics
NPI:1114588837
Name:KUSUMA PRINGLE, MONIKA (MD)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:
Last Name:KUSUMA PRINGLE
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 1:3600 FORBES AVENUE
Mailing Address - Street 2:FORBES TOWER - PLAZA LEVEL SUITE 140
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:814-534-9364
Mailing Address - Fax:814-534-5599
Practice Address - Street 1:ALTOONA FAMILY PHYSICIAN
Practice Address - Street 2:501 HOWARD AVENUE SUITE F2
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16607
Practice Address - Country:US
Practice Address - Phone:814-889-2020
Practice Address - Fax:814-534-5599
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT218175207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine