Healthcare Provider Details

I. General information

NPI: 1386641181
Provider Name (Legal Business Name): BARRY NEIL KUTNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 OXFORD VALLEY RD SUITE 801-A
YARDLEY PA
19067-7706
US

IV. Provider business mailing address

301 OXFORD VALLEY RD SUITE 801-A
YARDLEY PA
19067-7706
US

V. Phone/Fax

Practice location:
  • Phone: 215-493-7330
  • Fax:
Mailing address:
  • Phone: 215-493-7330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD029388E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: