Provider Demographics
NPI:1497720635
Name:KUMAR, AWANI (MD)
Entity Type:Individual
Prefix:
First Name:AWANI
Middle Name:
Last Name:KUMAR
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 1:780 HWY 37 W
Mailing Address - Street 2:SUITE 110
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5014
Mailing Address - Country:US
Mailing Address - Phone:732-341-3500
Mailing Address - Fax:
Practice Address - Street 1:780 HWY 37 W
Practice Address - Street 2:SUITE 110
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5014
Practice Address - Country:US
Practice Address - Phone:732-341-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 66307207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7568703Medicaid
009649UB9Medicare PIN
NJF 60572Medicare UPIN