Provider Demographics
NPI:1396827697
Name:KUMAR, KUSUM (MD)
Entity Type:Individual
Prefix:DR
First Name:KUSUM
Middle Name:
Last Name:KUMAR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:760 BROADWAY, DEPARTMENT OF PEDIATRICS 2B-321
Mailing Address - Street 2:WOODHULL MEDICAL & MENTAL HEALTH CENTER
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206
Mailing Address - Country:US
Mailing Address - Phone:718-963-8214
Mailing Address - Fax:718-630-3122
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:WOODHULL MEDICAL & MENTAL HEALTH CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-963-8000
Practice Address - Fax:718-630-3122
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2014-04-29
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Provider Licenses
StateLicense IDTaxonomies
NY1362122080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6716322Medicaid