Provider Demographics
NPI:1720172836
Name:KURTZ, CAROLINE PAULA (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:PAULA
Last Name:KURTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 STEVENS STREET
Mailing Address - Street 2:SUITE C
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850
Mailing Address - Country:US
Mailing Address - Phone:203-855-3888
Mailing Address - Fax:203-855-3966
Practice Address - Street 1:30 STEVENS STREET
Practice Address - Street 2:SUITE C
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850
Practice Address - Country:US
Practice Address - Phone:203-855-3888
Practice Address - Fax:203-855-3966
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT031255207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001312553Medicaid
CT001312553Medicaid
CT290000225Medicare ID - Type Unspecified