Provider Demographics
NPI:1811586548
Name:KUTNER, STEVEN JAY (RPH)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAY
Last Name:KUTNER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13951 SPRINGSTONE DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:VA
Mailing Address - Zip Code:20124-2345
Mailing Address - Country:US
Mailing Address - Phone:703-347-4975
Mailing Address - Fax:
Practice Address - Street 1:13951 SPRINGSTONE DR
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:VA
Practice Address - Zip Code:20124-2345
Practice Address - Country:US
Practice Address - Phone:703-347-4975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-17
Last Update Date:2021-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD081081835G0303X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric