Healthcare Provider Details

I. General information

NPI: 1821917592
Provider Name (Legal Business Name): SUMIT KUKREJA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 VERMONT AVE
CONGERS NY
10920-2423
US

IV. Provider business mailing address

33 VERMONT AVE
CONGERS NY
10920-2423
US

V. Phone/Fax

Practice location:
  • Phone: 516-830-5741
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number14000084498
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: