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General NPI Number Information
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NPI Number | 1841559812
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Entity Type | Organization
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Legal Business Name | RICHARD M KUSHNER, DPM, LLC
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Dates
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Enumeration Date | 05/11/2012
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Last Update Date | 05/11/2012
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Provider Practice Location Address
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Address Line | 580 PARK AVENUE SUITE 1C
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City | NEW YORK
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State | NY
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Zip | 10065-7313
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Country | US
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Telephone | 212-355-2875
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Fax | 212-355-0537
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Provider Business Mailing Address
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Address Line | 580 PARK AVENUE SUITE 1C
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City | NEW YORK
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State | NY
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Zip | 10065-7313
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Country | US
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Telephone | 212-355-2875
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Fax | 212-355-0537
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD MICHAEL KUSHNER
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Credential | DPM
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Telephone | 212-355-2875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 002333
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License Number State | NY
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