Provider Demographics
NPI:1427618719
Name:SURESH KUMAR, VASUPRADHA (MD)
Entity type:Individual
Prefix:DR
First Name:VASUPRADHA
Middle Name:
Last Name:SURESH 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 1:117 ELLENFIELD ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-4541
Mailing Address - Country:US
Mailing Address - Phone:401-444-6779
Mailing Address - Fax:401-444-6912
Practice Address - Street 1:701 GEORGE WASHINGTON HWY STE 104
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4299
Practice Address - Country:US
Practice Address - Phone:401-606-8052
Practice Address - Fax:401-606-8055
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10242222080P0202X
RIMD207172080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty