Provider Demographics
NPI:1639761422
Name:KAPUR, RIAD
Entity Type:Individual
Prefix:
First Name:RIAD
Middle Name:
Last Name:KAPUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-6304
Mailing Address - Country:US
Mailing Address - Phone:973-405-0038
Mailing Address - Fax:
Practice Address - Street 1:105 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-6304
Practice Address - Country:US
Practice Address - Phone:973-405-0038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer