Healthcare Provider Details

I. General information

NPI: 1427753516
Provider Name (Legal Business Name): BABAN KUMAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 MAIN RD
CORFU NY
14036-9753
US

IV. Provider business mailing address

860 MAIN RD
CORFU NY
14036-9753
US

V. Phone/Fax

Practice location:
  • Phone: 585-599-6446
  • Fax: 585-599-6446
Mailing address:
  • Phone: 585-599-6446
  • Fax: 585-637-2375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number345543
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: