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Contact Information

KUMAR MADOM, MD
5225 NESCONSET HWY
SUITE 35
PORT JEFFERSON STATION, NY11776
 Phone: 631-331-3232
 Fax: 631-928-4910
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for KUMAR MADOM · (Male)

NPI Number 1174612964
Status Active
Credentials MD
Entity Individual
Enumeration date 10/12/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 115212
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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