Provider Demographics
NPI:1710964366
Name:KURTZMAN, DAVID (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:KURTZMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2735
Mailing Address - Country:US
Mailing Address - Phone:610-363-2808
Mailing Address - Fax:610-363-6638
Practice Address - Street 1:315 E LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2735
Practice Address - Country:US
Practice Address - Phone:610-363-2808
Practice Address - Fax:610-363-6638
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000932152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT29479Medicare UPIN