Provider Demographics
NPI:1245331719
Name:KENNETH KURTZ PHYSICAL THERAPY & ASSOCIATES
Entity type:Organization
Organization Name:KENNETH KURTZ PHYSICAL THERAPY & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:KURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-631-1212
Mailing Address - Street 1:8705 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6317
Mailing Address - Country:US
Mailing Address - Phone:716-631-1212
Mailing Address - Fax:716-631-1363
Practice Address - Street 1:8705 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6317
Practice Address - Country:US
Practice Address - Phone:716-631-1212
Practice Address - Fax:716-631-1363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA0322Medicare ID - Type Unspecified