Individual
DR. AYUSH LACOUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(800) 879-2467
Mailing address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(800) 879-2467
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MD480541
PA
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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