Provider Demographics
NPI:1124231014
Name:KURAS, MARK FRANCIS (PHD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:FRANCIS
Last Name:KURAS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 MALONE ROAD
Mailing Address - Street 2:
Mailing Address - City:SALT POINT
Mailing Address - State:NY
Mailing Address - Zip Code:12578
Mailing Address - Country:US
Mailing Address - Phone:845-266-4581
Mailing Address - Fax:
Practice Address - Street 1:20 WEST 86TH ST. #1D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:212-724-1793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011275103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV8C671Medicare ID - Type UnspecifiedMEDICARE PROVIDER #