Provider Demographics
NPI:1700171691
Name:KUMAR, AVISHEK (MD)
Entity type:Individual
Prefix:DR
First Name:AVISHEK
Middle Name:
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2177 OAK TREE RD STE 107
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1082
Mailing Address - Country:US
Mailing Address - Phone:908-755-1165
Mailing Address - Fax:908-755-2093
Practice Address - Street 1:908 OAK TREE ROAD
Practice Address - Street 2:SUITE 104
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820
Practice Address - Country:US
Practice Address - Phone:908-755-1165
Practice Address - Fax:908-755-2093
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-18
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38872193200000X
NJ25MA08941000207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
No193200000XGroupMulti-Specialty