Healthcare Provider Details

I. General information

NPI: 1255318515
Provider Name (Legal Business Name): JOSHUA N. KUGLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HEALTHY WAY
OCEANSIDE NY
11572-1551
US

IV. Provider business mailing address

PO BOX 826223
PHILADELPHIA PA
19182-6223
US

V. Phone/Fax

Practice location:
  • Phone: 516-632-3900
  • Fax:
Mailing address:
  • Phone: 866-898-7142
  • Fax: 770-237-1723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number216350
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: