Provider Demographics
NPI:1568490894
Name:KUO, JOHN S (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:S
Last Name:KUO
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 1:4 NESHAMINY INTERPLEX
Mailing Address - Street 2:SUITE 209
Mailing Address - City:TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6940
Mailing Address - Country:US
Mailing Address - Phone:215-244-3070
Mailing Address - Fax:215-638-9041
Practice Address - Street 1:4 NESHAMINY INTERPLEX
Practice Address - Street 2:SUITE 209
Practice Address - City:TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6940
Practice Address - Country:US
Practice Address - Phone:215-244-3070
Practice Address - Fax:215-638-9041
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0754092085R0202X
NJ25MA075409002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0007153Medicaid
NJP00286400OtherRAILROAD MEDICARE
G18345Medicare UPIN
NJ068356VSBMedicare PIN
NJ068356Medicare PIN