Individual
KAOSOLUCHI ENENDU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-9800
(570) 271-6516
(570) 271-5814
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6516
(570) 271-5814
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
75155
CT
2084P0800X
Psychiatry Physician
Primary
A197583
CA
2084P0800X
Psychiatry Physician
MD494104
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2021
Last updated
04/23/2026
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