Basic Information
| Provider Information | |||||||||
| NPI: | 1336280304 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KUMAR | ||||||||
| FirstName: | AMIT | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CHHABRA | ||||||||
| OtherFirstName: | AMIT | ||||||||
| OtherMiddleName: | KUMAR | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 28810 CHAGRIN BLVD | ||||||||
| Address2: | APT. # 111 | ||||||||
| City: | WOODMERE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441224627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2165142624 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1445 PORTLAND AVE | ||||||||
| Address2: | POB SUITE 301 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146213036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5859224840 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 230289 | NY | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.