Provider Demographics
NPI:1629055157
Name:KUCER, KATHLEEN ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:ANNE
Last Name:KUCER
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 1:817 LAWN AVE
Mailing Address - Street 2:UPPER BUCKS MEDICAL ARTS BUILDING
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-1549
Mailing Address - Country:US
Mailing Address - Phone:215-257-0196
Mailing Address - Fax:215-257-1211
Practice Address - Street 1:817 LAWN AVE
Practice Address - Street 2:UPPER BUCKS MEDICAL ARTS BUILDING
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1549
Practice Address - Country:US
Practice Address - Phone:215-257-0196
Practice Address - Fax:215-257-1211
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019489E207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001542601Medicaid
PAP00471551Medicare PIN
B38369Medicare UPIN
PA001542601Medicaid
PA080080Medicare PIN