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General NPI Number Information
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NPI Number | 1821089087
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Entity Type | Individual
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Provider Name | ILANA B KUTINSKY DO
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Gender | Female
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Dates
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Enumeration Date | 11/04/2005
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Last Update Date | 10/23/2020
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Provider Practice Location Address
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Address Line | 4600 INVESTMENT DR SUITE 200
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City | TROY
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State | MI
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Zip | 48098-6365
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Country | US
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Telephone | 248-267-5050
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Fax | 248-267-5051
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Provider Business Mailing Address
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Address Line | 4600 INVESTMENT DR SUITE 200
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City | TROY
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State | MI
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Zip | 48098-6365
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Country | US
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Telephone | 248-267-5050
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Fax | 248-267-5051
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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 | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 35340
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 5101015554
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License Number State | MI
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