Provider Demographics
NPI:1205866746
Name:KUTVOELGYI, ERIN E (DPM)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:E
Last Name:KUTVOELGYI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:ERIN
Other - Middle Name:E
Other - Last Name:MCGOVERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:43 STONERIDGE RD
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:PA
Mailing Address - Zip Code:19373-1042
Mailing Address - Country:US
Mailing Address - Phone:610-357-6303
Mailing Address - Fax:484-730-0060
Practice Address - Street 1:500 ORCHARD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-1812
Practice Address - Country:US
Practice Address - Phone:610-388-8637
Practice Address - Fax:484-730-0060
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005540L213E00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001904101Medicaid
PA001904101Medicaid
PA060032D0KMedicare PIN
U91222Medicare UPIN
DE009925F28Medicare PIN
PA060032D0KMedicare PIN
DE1000032783Medicaid