Healthcare Provider Details

I. General information

NPI: 1679693402
Provider Name (Legal Business Name): ELIZABETH N. KUH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 CYNWYD RD
BALA CYNWYD PA
19004-3306
US

IV. Provider business mailing address

3 CYNWYD RD
BALA CYNWYD PA
19004-3306
US

V. Phone/Fax

Practice location:
  • Phone: 610-667-2030
  • Fax: 610-667-6214
Mailing address:
  • Phone: 610-667-2030
  • Fax: 610-667-6214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD036447E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: