Provider Demographics
NPI:1073929873
Name:KURTZ, JOSEPH EVAN (CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:EVAN
Last Name:KURTZ
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 COOPER ST
Mailing Address - Street 2:P53K@384, 3RD FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-1311
Mailing Address - Country:US
Mailing Address - Phone:347-819-3331
Mailing Address - Fax:
Practice Address - Street 1:242 COOPER ST
Practice Address - Street 2:P53K@384, 3RD FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-1311
Practice Address - Country:US
Practice Address - Phone:347-819-3331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020322-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist