| Pushparanee Babusukumar M.d.s.c. | |
|
3535 30th Ave Suite 201 Kenosha WI 53144-1632 | |
| (262) 652-7813 | |
| (262) 652-4450 |
| Full Name | Pushparanee Babusukumar M.d.s.c. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 3535 30th Ave, Kenosha, Wisconsin |
| Authorized Official Name and Position | Pushparanee Babusukumar (PRESIDENT) |
| Authorized Official Contact | 2626527813 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pushparanee Babusukumar M.d.s.c. 3535 30th Ave Suite 201 Kenosha WI 53144-1632 Ph: (262) 652-7813 | Pushparanee Babusukumar M.d.s.c. 3535 30th Ave Suite 201 Kenosha WI 53144-1632 Ph: (262) 652-7813 |
| NPI Number | 1528254042 |
|---|---|
| Provider Enumeration Date | 09/18/2007 |
| Last Update Date | 09/18/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528254042 | NPI | - | NPPES |
| 31964500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 33930 (Wisconsin) | Primary |
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