Healthcare Provider Details

I. General information

NPI: 1265772701
Provider Name (Legal Business Name): OLIVER KURUCZ MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2013
Last Update Date: 02/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N MIDDLETOWN RD SUITE 11
PEARL RIVER NY
10965-1262
US

IV. Provider business mailing address

300 N MIDDLETOWN RD SUITE 11
PEARL RIVER NY
10965-1262
US

V. Phone/Fax

Practice location:
  • Phone: 845-735-4114
  • Fax: 845-732-8425
Mailing address:
  • Phone: 845-735-4114
  • Fax: 845-732-8425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number223243
License Number StateNY

VIII. Authorized Official

Name: DR. OLIVER S KURUCZ
Title or Position: OWNER
Credential: M.D.
Phone: 845-735-4114