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General NPI Number Information
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NPI Number | 1427618719
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Entity Type | Individual
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Provider Name | VASUPRADHA SURESH KUMAR MD
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Gender | Female
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Dates
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Enumeration Date | 06/18/2019
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 701 GEORGE WASHINGTON HWY STE 104
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City | LINCOLN
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State | RI
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Zip | 02865-4299
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Country | US
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Telephone | 401-606-8052
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Fax | 401-606-8055
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Provider Business Mailing Address
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Address Line | 117 ELLENFIELD ST STE 101
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City | PROVIDENCE
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State | RI
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Zip | 02905-4541
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Country | US
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Telephone | 401-444-6779
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Fax | 401-444-6912
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 1024222
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | MD20717
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License Number State | RI
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