Healthcare Provider Details

I. General information

NPI: 1477939098
Provider Name (Legal Business Name): MICHAEL KUHAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2015
Last Update Date: 08/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5437 MILL ST
ERIE PA
16509-2919
US

IV. Provider business mailing address

5437 MILL ST
ERIE PA
16509-2919
US

V. Phone/Fax

Practice location:
  • Phone: 954-649-8212
  • Fax:
Mailing address:
  • Phone: 954-649-8212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number14115
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: