Provider Demographics
NPI:1437154085
Name:KURTZER, CHARLES MICHAEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:MICHAEL
Last Name:KURTZER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E NORTHFIELD RD
Mailing Address - Street 2:STE 1B
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4800
Mailing Address - Country:US
Mailing Address - Phone:973-992-0002
Mailing Address - Fax:973-740-1413
Practice Address - Street 1:315 E NORTHFIELD RD
Practice Address - Street 2:STE 1B
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4800
Practice Address - Country:US
Practice Address - Phone:973-992-0002
Practice Address - Fax:973-740-1413
Is Sole Proprietor?:No
Enumeration Date:2005-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD001379213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
T77769Medicare UPIN