Provider Demographics
NPI:1396849071
Name:KURTZ, ARTHUR SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:SAMUEL
Last Name:KURTZ
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 1:3 KENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-2049
Mailing Address - Country:US
Mailing Address - Phone:631-334-8800
Mailing Address - Fax:
Practice Address - Street 1:16 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-3337
Practice Address - Country:US
Practice Address - Phone:631-928-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169716207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01283361Medicaid
NY07E731Medicare ID - Type Unspecified
NY01283361Medicaid