Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | F5675 | CA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD446148 | PA |
NPI | 1528335775 |
---|---|
Provider Name | Dr. Pradeep Kumar Kaushik |
First Address | Philadelphia, PA 19104 |
Second Address | Philadelphia, PA 19104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2011 |
Last Update Date | 10/10/2012 |