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General NPI Number Information
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NPI Number | 1588125975
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Entity Type | Individual
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Provider Name | SUNKESULA KRISHNASAI KAUSHIK SAGAR DO
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Gender | Male
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Dates
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Enumeration Date | 03/27/2019
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 68 SPRING ST
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City | LOCK HAVEN
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State | PA
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Zip | 17745-1911
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Country | US
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Telephone | 800-230-4565
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Fax | 570-893-6325
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Provider Business Mailing Address
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Address Line | 100 N ACADEMY AVE
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City | DANVILLE
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State | PA
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Zip | 17822-4903
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Country | US
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Telephone | 800-230-4565
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Fax | 570-893-6325
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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 | OS021940
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License Number State | PA
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