Provider Demographics
NPI:1275509655
Name:KURTZ, ROBERT J (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:KURTZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:BOX 1263
Mailing Address - Street 2:1 GUSTAVE L LEVY PL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-241-7646
Mailing Address - Fax:212-534-4079
Practice Address - Street 1:5 EAST 98TH STREET
Practice Address - Street 2:14TH FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-7646
Practice Address - Fax:212-534-4079
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY122386208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00382792Medicaid
C08045Medicare UPIN
NY30A811Medicare ID - Type Unspecified