Healthcare Provider Details

I. General information

NPI: 1043638323
Provider Name (Legal Business Name): ERIC JAMES KUO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 FT WASHINGTN AVE FL 8
NEW YORK NY
10032-3729
US

IV. Provider business mailing address

301 W 57TH ST APT 10E
NEW YORK NY
10019-3163
US

V. Phone/Fax

Practice location:
  • Phone: 212-304-7818
  • Fax:
Mailing address:
  • Phone: 626-354-6885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA141216
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number309750
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: