Provider Demographics
NPI:1770548810
Name:VOELLMICKE, KURT V (MD)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:V
Last Name:VOELLMICKE
Suffix:
Gender:M
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:PO BOX 29234
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-9234
Mailing Address - Country:US
Mailing Address - Phone:203-391-2275
Mailing Address - Fax:203-391-2277
Practice Address - Street 1:276 POST RD W
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06889-3412
Practice Address - Country:US
Practice Address - Phone:203-291-2275
Practice Address - Fax:203-391-2277
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT40208207X00000X
NY208465207XX0004X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP2678086OtherOXFORD
NY02457445Medicaid
NYP2678086OtherOXFORD
H73270Medicare UPIN