Provider Demographics
NPI:1376517847
Name:KAUSHIK, NEERAJ (MD)
Entity Type:Individual
Prefix:DR
First Name:NEERAJ
Middle Name:
Last Name:KAUSHIK
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 1:2200 NORTHERN BLVD STE 212
Mailing Address - Street 2:
Mailing Address - City:GREENVALE
Mailing Address - State:NY
Mailing Address - Zip Code:11548-1220
Mailing Address - Country:US
Mailing Address - Phone:516-437-6900
Mailing Address - Fax:
Practice Address - Street 1:2200 NORTHERN BLVD STE 212
Practice Address - Street 2:
Practice Address - City:GREENVALE
Practice Address - State:NY
Practice Address - Zip Code:11548-1220
Practice Address - Country:US
Practice Address - Phone:516-590-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241494174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1376517847Medicare PIN
PAG56112Medicare UPIN