Provider Demographics
NPI:1114588837
Name:KUSUMA PRINGLE, MONIKA (MD)
Entity type:Individual
Prefix:
First Name:MONIKA
Middle Name:
Last Name:KUSUMA PRINGLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 FRANKLIN STREET
Mailing Address - Street 2:FAMILY MEDICAL CENTER
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905
Mailing Address - Country:US
Mailing Address - Phone:814-534-9106
Mailing Address - Fax:814-534-3136
Practice Address - Street 1:DLP CONEMAUGH MEMORIAL MEDICAL CENTER
Practice Address - Street 2:1020 FRANKLIN STREET SUITE 202
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905
Practice Address - Country:US
Practice Address - Phone:814-534-1722
Practice Address - Fax:814-534-1814
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2024-06-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD483669207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine