Provider Demographics
NPI:1164464608
Name:KAUSHIK, RAJ RAMANUJ (MD)
Entity type:Individual
Prefix:DR
First Name:RAJ
Middle Name:RAMANUJ
Last Name:KAUSHIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:145 HOSPITAL AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1462
Mailing Address - Country:US
Mailing Address - Phone:814-375-2040
Mailing Address - Fax:814-375-2045
Practice Address - Street 1:145 HOSPITAL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1462
Practice Address - Country:US
Practice Address - Phone:814-375-2040
Practice Address - Fax:814-375-2045
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04686900208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA374841GY7OtherMEDICARE-PH EKG READERS DUBOIS
NY02712641Medicaid
NJ060053620OtherRAILROAD MEDICARE
PA1029609210001Medicaid
NJ8093903Medicaid
NJ0215406Medicaid
PA374841WASOtherMEDICARE-PH DUBOIS CV SERVICES