Individual
BASANT KUMAR MITTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
511 PIERCE ST, KINGSTON, PA 18704-5731
(570) 714-3333
(570) 338-3993
Mailing address
PO BOX 1885, KINGSTON, PA 18704-0885
(570) 714-3333
(570) 338-3993
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD-039080-L
PA
208000000X
Pediatrics Physician
MD-039080-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102576296
—
PA
Enumeration date
12/28/2006
Last updated
05/08/2026
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