Provider Demographics
NPI:1679671101
Name:KUKORA, JOHN S (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:S
Last Name:KUKORA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1245 HIGHLAND AVE
Mailing Address - Street 2:STE 604
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3763
Mailing Address - Country:US
Mailing Address - Phone:215-481-7464
Mailing Address - Fax:215-481-2159
Practice Address - Street 1:1245 HIGHLAND AVE
Practice Address - Street 2:STE 305
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3763
Practice Address - Country:US
Practice Address - Phone:215-481-7462
Practice Address - Fax:215-481-3975
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD032801E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B41980Medicare UPIN
0000452993Medicare ID - Type Unspecified