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General NPI Number Information
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NPI Number | 1063504330
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Entity Type | Organization
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Legal Business Name | KUSUM KAPOOR,MD,PA
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1553 STATE ROUTE 27 SUITE 1800
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City | SOMERSET
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State | NJ
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Zip | 08873
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Country | US
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Telephone | 732-828-4850
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Fax |
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Provider Business Mailing Address
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Address Line | 1553 STATE ROUTE 27 SUITE 1800
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City | SOMERSET
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State | NJ
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Zip | 08873
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Country | US
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Telephone | 732-828-4850
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Fax |
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Authorized Official
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Title or Position | ADVISOR
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Name | MR. ANDY DESHPANDE
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Credential |
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Telephone | 732-828-4850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 25MA03734400
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License Number State | NJ
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