Provider Demographics
NPI:1073513412
Name:KUC, CHRISTOPHER J (OD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:KUC
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3475 W CHESTER PIKE STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-4281
Mailing Address - Country:US
Mailing Address - Phone:610-422-7999
Mailing Address - Fax:610-422-7988
Practice Address - Street 1:3475 W CHESTER PIKE STE 100
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-4281
Practice Address - Country:US
Practice Address - Phone:610-422-7999
Practice Address - Fax:610-422-7988
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001266152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1073513412Medicaid
PA1073513412Medicaid
VA536662OtherANTHEM BCBS
VA1073513412OtherTRICARE/TRICARE FOR LIFE
VA1073513412OtherHUMANA
VAP01401759OtherRR MEDICARE
VA10139953OtherOPTIMA
VA1073513412OtherUNITED HEALTHCARE
VA7357993OtherCIGNA