Provider Demographics
NPI:1689770026
Name:KURILOFF, DANIEL B (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:B
Last Name:KURILOFF
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:PO BOX 20988
Mailing Address - Street 2:COLUMBUS CIRCLE STATION
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-1490
Mailing Address - Country:US
Mailing Address - Phone:212-262-4444
Mailing Address - Fax:212-523-8165
Practice Address - Street 1:425 W 59TH ST FL 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-8022
Practice Address - Country:US
Practice Address - Phone:212-262-4444
Practice Address - Fax:212-523-8165
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168058174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01263116Medicaid
NYA61486Medicare UPIN
NYW5F051Medicare PIN
NY01263116Medicaid