Individual
JEEVAN KUMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
190 MAPLE RD, AMHERST, NY 14221-3129
(716) 580-3810
Mailing address
190 MAPLE RD, AMHERST, NY 14221-3129
(972) 523-0013
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT208853
PA
207RC0000X
Cardiovascular Disease Physician
Primary
308907
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07027407
—
NY
Enumeration date
05/13/2015
Last updated
08/23/2022
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