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NPI Code Detail

MEDICARE: DR. TERRANCE JAMES KUKOR PH.D.

MEDICARE:  DR. TERRANCE JAMES KUKOR  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TF0200XForensic Psychologist5594OH

General Provider Information

NPI Number : 1205343241
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERRANCE JAMES KUKOR PH.D.
Provider Business Mailing Address
First Line : 3081 SULLIVANT AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43204-1831
Country : US
Telephone Number : 614-278-0152
Fax Number :
Provider Business Practice Location Address
First Line : 3081 SULLIVANT AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43204-1831
Country : US
Telephone Number : 614-278-0152
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2017
Last Update Date : 12/29/2017

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Directions to “ DR. TERRANCE JAMES KUKOR PH.D.” Practice Location

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