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General NPI Number Information
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NPI Number | 1366968703
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Entity Type | Individual
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Provider Name | JOSHUA KARL KUTINSKY PSYD
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Gender | Male
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Dates
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Enumeration Date | 08/17/2017
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Last Update Date | 08/17/2017
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Provider Practice Location Address
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Address Line | 1528 WALNUT ST STE 1500
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3611
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Country | US
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Telephone | 215-735-2505
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Fax |
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Provider Business Mailing Address
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Address Line | 1810 N 71ST ST
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City | PHILADELPHIA
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State | PA
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Zip | 19151-2306
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Country | US
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Telephone | 610-742-4936
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | PS017496
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License Number State | PA
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