Provider Demographics
NPI:1740976992
Name:DR. ORNELA KUTZKE LLC
Entity type:Organization
Organization Name:DR. ORNELA KUTZKE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:ORNELA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUTZKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-704-0465
Mailing Address - Street 1:7220 WISCONSIN AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4855
Mailing Address - Country:US
Mailing Address - Phone:301-941-7521
Mailing Address - Fax:301-235-1546
Practice Address - Street 1:7220 WISCONSIN AVE STE 200
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4855
Practice Address - Country:US
Practice Address - Phone:301-941-7521
Practice Address - Fax:301-235-1546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-12
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty