Provider Demographics
NPI:1699303552
Name:PANARA, KUSH (MD)
Entity type:Individual
Prefix:
First Name:KUSH
Middle Name:
Last Name:PANARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 BELFORD CT
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4210
Mailing Address - Country:US
Mailing Address - Phone:407-575-2655
Mailing Address - Fax:
Practice Address - Street 1:3400 SPRUCE ST FL 5
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4229
Practice Address - Country:US
Practice Address - Phone:407-575-2655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program