Provider Demographics
NPI:1548431349
Name:AMIN, KAUSHA JAY (MD)
Entity Type:Individual
Prefix:MRS
First Name:KAUSHA
Middle Name:JAY
Last Name:AMIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:KAUSHA
Other - Middle Name:RAVI
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 79906
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-0906
Mailing Address - Country:US
Mailing Address - Phone:240-566-1600
Mailing Address - Fax:240-566-1605
Practice Address - Street 1:9901 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3357
Practice Address - Country:US
Practice Address - Phone:240-566-1600
Practice Address - Fax:240-566-1605
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD0071318207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program