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General NPI Number Information
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NPI Number | 1619900065
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Entity Type | Individual
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Provider Name | PANKAJ KULSHRESTHA MD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 09/28/2021
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Provider Practice Location Address
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Address Line | 3219 CENTRAL AVE STE 201
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City | KEARNEY
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State | NE
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Zip | 68847-2903
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Country | US
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Telephone | 917-536-6453
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Fax |
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Provider Business Mailing Address
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Address Line | 3707 28TH AVE
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City | KEARNEY
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State | NE
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Zip | 68845-1258
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Country | US
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Telephone | 917-536-6453
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Fax |
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 33767
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License Number State | NE
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