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General NPI Number Information
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NPI Number | 1538414982
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Entity Type | Individual
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Provider Name | MANISH KUMAR M.D
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Gender | Male
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Dates
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Enumeration Date | 07/20/2012
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Last Update Date | 04/02/2016
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Provider Practice Location Address
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Address Line | 25012 HILLSIDE AVE SUITE B
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City | BELLEROSE
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State | NY
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Zip | 11426-2100
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Country | US
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Telephone | 718-470-0126
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Fax | 718-470-0128
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Provider Business Mailing Address
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Address Line | 13 WILTON ST
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-3829
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Country | US
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Telephone | 718-470-0126
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Fax | 718-470-0128
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 265895
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License Number State | NY
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