Provider Demographics
NPI:1578928057
Name:KUGLER, JOHN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:KUGLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7721 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-2341
Mailing Address - Country:US
Mailing Address - Phone:718-530-4042
Mailing Address - Fax:
Practice Address - Street 1:251 E 5TH ST
Practice Address - Street 2:SUITE 115
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2403
Practice Address - Country:US
Practice Address - Phone:718-530-4042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013466103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist