Provider Demographics
NPI:1396851176
Name:KURITZKY, JEFFREY IRA (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:IRA
Last Name:KURITZKY
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 1:440 E 57TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3045
Mailing Address - Country:US
Mailing Address - Phone:212-759-5460
Mailing Address - Fax:212-759-7080
Practice Address - Street 1:440 E 57TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3045
Practice Address - Country:US
Practice Address - Phone:212-759-5460
Practice Address - Fax:212-759-7080
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197129207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
18U711Medicare ID - Type Unspecified
G92550Medicare UPIN