Provider Demographics
NPI:1790753473
Name:KUKFA, MICHAEL ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALAN
Last Name:KUKFA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10 HAGEN DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2660
Mailing Address - Country:US
Mailing Address - Phone:585-385-5555
Mailing Address - Fax:585-385-5611
Practice Address - Street 1:10 HAGEN DR
Practice Address - Street 2:SUITE 350
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2660
Practice Address - Country:US
Practice Address - Phone:585-385-5555
Practice Address - Fax:585-385-5611
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY175129207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1243594Medicaid
E85796Medicare UPIN
RA5751Medicare ID - Type Unspecified