Provider Demographics
NPI:1245579275
Name:KUK, RICHARD T (RPH)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:T
Last Name:KUK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 E ALLEGHENY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-2327
Mailing Address - Country:US
Mailing Address - Phone:215-423-8500
Mailing Address - Fax:215-423-8400
Practice Address - Street 1:424 E ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-2327
Practice Address - Country:US
Practice Address - Phone:215-423-8500
Practice Address - Fax:215-423-8400
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP045839L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist