Healthcare Provider Details

I. General information

NPI: 1477473767
Provider Name (Legal Business Name): UNKNOWN MILAN KUMAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2389 7TH AVE FL 2
NEW YORK NY
10030-0630
US

IV. Provider business mailing address

20TH RIVER CT APT. 2405, NEW SOUTHHAMPTON
JERSEY CITY NJ
07310
US

V. Phone/Fax

Practice location:
  • Phone: 646-448-4900
  • Fax:
Mailing address:
  • Phone: 213-994-8080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberP138281
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: