Healthcare Provider Details

I. General information

NPI: 1346242476
Provider Name (Legal Business Name): DAVID KUTLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 YORK AVE FL 5
NEW YORK NY
10021-5663
US

IV. Provider business mailing address

160 E 34TH ST 9TH FL
NEW YORK NY
10016-4744
US

V. Phone/Fax

Practice location:
  • Phone: 646-962-4323
  • Fax:
Mailing address:
  • Phone: 212-731-5329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number220842
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: