Healthcare Provider Details

I. General information

NPI: 1831262583
Provider Name (Legal Business Name): DAVID JOSEPH KUCHAR DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 S WASHINGTON AVE
BERGENFIELD NJ
07621-3739
US

IV. Provider business mailing address

253 S WASHINGTON AVE
BERGENFIELD NJ
07621-3739
US

V. Phone/Fax

Practice location:
  • Phone: 201-385-7373
  • Fax: 201-385-1831
Mailing address:
  • Phone: 201-385-7373
  • Fax: 201-385-1831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberMD 02614
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: