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General NPI Number Information
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NPI Number | 1821210402
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Entity Type | Organization
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Legal Business Name | CROWN HEIGHTS MEDICAL, P.C.
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 1 MAIN ST
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City | MONSEY
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State | NY
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Zip | 10952-3704
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Country | US
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Telephone | 845-371-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 12 DEERWOOD RD
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City | SPRING VALLEY
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State | NY
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Zip | 10977-1001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SETH DAVID KURTZ
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Credential | MD
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Telephone | 845-371-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 232596
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License Number State | NY
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