Provider Demographics
NPI:1598895187
Name:KUCHINSKI, KIMBERLY S (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:S
Last Name:KUCHINSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 S 5TH STREET
Mailing Address - Street 2:5TH FLOOR BILLING
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-3295
Mailing Address - Country:US
Mailing Address - Phone:610-778-9297
Mailing Address - Fax:610-778-9270
Practice Address - Street 1:850 S. 5TH STREET
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-3295
Practice Address - Country:US
Practice Address - Phone:610-776-3278
Practice Address - Fax:610-776-3326
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC7-00030502081P0010X
PAMT1840652081P0010X
PAMD436593208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023084370001Medicaid