Provider Demographics
NPI:1851640643
Name:JEFFREY A KURTA MEDICAL SERVICES PC
Entity Type:Organization
Organization Name:JEFFREY A KURTA MEDICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KURTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-678-0300
Mailing Address - Street 1:143 N LONG BEACH RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4438
Mailing Address - Country:US
Mailing Address - Phone:516-678-0300
Mailing Address - Fax:516-678-9171
Practice Address - Street 1:143 N LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4438
Practice Address - Country:US
Practice Address - Phone:516-678-0300
Practice Address - Fax:516-678-9171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143992174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty