Provider Demographics
NPI:1902880255
Name:KUMAR, SMITA RAJEEV (MD)
Entity Type:Individual
Prefix:
First Name:SMITA
Middle Name:RAJEEV
Last Name:KUMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 PHEASANT RUN
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3141
Mailing Address - Country:US
Mailing Address - Phone:718-231-6565
Mailing Address - Fax:718-231-8477
Practice Address - Street 1:4350 VAN CORTLANDT PARK E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10470-1875
Practice Address - Country:US
Practice Address - Phone:718-231-6565
Practice Address - Fax:718-231-8477
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163227207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400001420Medicare PIN
NYA400001419Medicare PIN