Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 174741 | NY |
Y | 207PP0204X | Pediatric Emergency Physician | 174741 | NY |
N | 208000000X | Pediatrician | 174741 | NY |
NPI | 1033171434 |
---|---|
Provider Name | Krishan Kumar |
First Address | Kew Gardens, NY 11415-1104 |
Second Address | Kew Gardens, NY 11415-1104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2006 |
Last Update Date | 23/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01079221 | (05) | NY |
A61480 | (02) | NY |