Provider Demographics
NPI:1467631986
Name:REBECCA J. KURTH, MD, FACP, PC
Entity Type:Organization
Organization Name:REBECCA J. KURTH, MD, FACP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:KURTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-230-1081
Mailing Address - Street 1:800A 5TH AVE
Mailing Address - Street 2:SUITE 502A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7215
Mailing Address - Country:US
Mailing Address - Phone:212-230-1081
Mailing Address - Fax:212-230-1359
Practice Address - Street 1:800A 5TH AVE
Practice Address - Street 2:SUITE 502A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7215
Practice Address - Country:US
Practice Address - Phone:212-230-1081
Practice Address - Fax:212-230-1359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY176213207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEW341Medicare PIN
NYE74460Medicare UPIN