Provider Demographics
NPI:1629500186
Name:KURTZ, JORDAN (MD)
Entity type:Individual
Prefix:MR
First Name:JORDAN
Middle Name:
Last Name:KURTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:32 STRAWBERRY HILL CT FL 4
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2594
Mailing Address - Country:US
Mailing Address - Phone:203-276-2473
Mailing Address - Fax:203-276-4758
Practice Address - Street 1:32 STRAWBERRY HILL CT FL 4
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2594
Practice Address - Country:US
Practice Address - Phone:203-276-2473
Practice Address - Fax:203-276-4758
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3097832084P0800X
CT699072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry