Provider Demographics
NPI:1366823841
Name:SUKHDEO, KUMAR (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:KUMAR
Middle Name:
Last Name:SUKHDEO
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 E 38TH ST
Mailing Address - Street 2:DERMATOLOGY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2708
Mailing Address - Country:US
Mailing Address - Phone:212-263-5015
Mailing Address - Fax:844-469-1474
Practice Address - Street 1:245 5TH AVENUE
Practice Address - Street 2:C/O LINA SUITE 311
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:929-376-8660
Practice Address - Fax:844-469-1474
Is Sole Proprietor?:No
Enumeration Date:2015-06-10
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125066625207R00000X
390200000X
NY295724-1207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program