Individual
KUSH R DHOLAKIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
233 E SHORE RD, SUITE 112, GREAT NECK, NY 11023-2433
(516) 482-7810
(516) 829-6887
Mailing address
PO BOX 64075, BALTIMORE, MD 21264-4075
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
D63326
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KX 46 / 646236-01
BC / BS OF MD
MD
01
—
S 185 / 0029
BLUECHOICE
MD
Enumeration date
06/09/2006
Last updated
07/08/2007
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