Healthcare Provider Details
I. General information
NPI: 1821071770
Provider Name (Legal Business Name): NATHANIEL STROOCK KUHN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/23/2005
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
68 LEONARD ST STE 201
BELMONT MA
02478-2576
US
IV. Provider business mailing address
405 CONCORD AVE UNIT 312
BELMONT MA
02478-7815
US
V. Phone/Fax
- Phone: 617-489-9090
- Fax: 870-201-5120
- Phone: 617-489-9090
- Fax: 870-201-5120
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 79826 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: