Provider Demographics
NPI:1326086273
Name:KURTTI, NEAL D (MD)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:D
Last Name:KURTTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ROUTE 59
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4927
Mailing Address - Country:US
Mailing Address - Phone:845-357-5775
Mailing Address - Fax:845-357-5777
Practice Address - Street 1:255 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4812
Practice Address - Country:US
Practice Address - Phone:845-368-5039
Practice Address - Fax:845-368-5327
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY180952-1207L00000X
NJ25MA05987400207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01251550Medicaid
NJ0016110Medicaid
NJP01043481OtherRAILROAD MEDICARE
NY050017338OtherRAILROAD MEDICARE
PA102786284Medicaid
NY050017338OtherRAILROAD MEDICARE
NJ020875T7YMedicare PIN
NJ0016110Medicaid