Basic Information
| Provider Information | |||||||||
| NPI: | 1831545466 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUMAR | ||||||||
| FirstName: | DEEPIKA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 310 CEDAR ST | ||||||||
| Address2: | |||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065103218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037853624 | ||||||||
| FaxNumber: | 2037857037 | ||||||||
| Practice Location | |||||||||
| Address1: | 310 CEDAR ST | ||||||||
| Address2: | YUSM, DEPARTMENT OF PATHOLOGY | ||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065103218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037374142 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2016 | ||||||||
| LastUpdateDate: | 04/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZH0000X | 65095 | CT | N | Allopathic & Osteopathic Physicians | Pathology | Hematology | 207ZP0101X | 65095 | CT | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207ZP0102X | 65095 | CT | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.