Healthcare Provider Details

I. General information

NPI: 1922298090
Provider Name (Legal Business Name): MATTHIAS CHRISTIAN KUGLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E 17TH ST
NEW YORK NY
10003-3804
US

IV. Provider business mailing address

608 W 140TH ST APT 46
NEW YORK NY
10031-7160
US

V. Phone/Fax

Practice location:
  • Phone: 212-598-6351
  • Fax: 212-517-2137
Mailing address:
  • Phone: 347-573-7528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number258606
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number258606
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: