# KAVITHA KUMBUM PHYSICIAN, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144458654
- **Authorized official:** KAVITHA KUMBUM MD (PRESIDENT)
- **Authorized official phone:** (201) 686-0155

## Contact information

- **Practice address:** 1650 GRAND CONCOURSE, BRONX, NY 10457
- **Practice address phone:** (201) 686-0155
- **Mailing address:** 17-34 HUNTER PLACE, FAIR LAWN, NJ 07410
- **Mailing address phone:** (201) 686-0155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | 227392 | NY | Yes |

## Other

- **Enumeration date:** 06/24/2009
- **Last updated:** 06/24/2009