Healthcare Provider Details

I. General information

NPI: 1629092192
Provider Name (Legal Business Name): DHARAMJIT NARENDRA KUMAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 11/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10314 LEFFERTS BLVD
JAMAICA NY
11419-2012
US

IV. Provider business mailing address

10314 LEFFERTS BLVD
JAMAICA NY
11419-2012
US

V. Phone/Fax

Practice location:
  • Phone: 718-843-2244
  • Fax:
Mailing address:
  • Phone: 718-843-2244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number154889
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number154889
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number154889
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: