Healthcare Provider Details

I. General information

NPI: 1437113099
Provider Name (Legal Business Name): KUCHARCZUK & SMITH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 06/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1357 MAIN ST
NORTHAMPTON PA
18067-1613
US

IV. Provider business mailing address

1357 MAIN ST
NORTHAMPTON PA
18067-1613
US

V. Phone/Fax

Practice location:
  • Phone: 610-262-9091
  • Fax: 610-262-1566
Mailing address:
  • Phone: 610-262-9091
  • Fax: 610-262-1566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD023597-L
License Number StatePA

VIII. Authorized Official

Name: JOHN B KUCHARCZUK
Title or Position: PRESIDENT
Credential: MD
Phone: 610-262-9091