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NPI Code Detail

MEDICARE: MARIAKUTTY JOSEPH M.D.

MEDICARE: MARIAKUTTY JOSEPH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician155774NY

General Provider Information

NPI Number : 1043229891
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIAKUTTY JOSEPH M.D.
Provider Business Mailing Address
First Line : 517 INDIAN PRINCESS DR
Second Line : APT204
City : LAS VEGAS
State : NV
Zip : 89145-2402
Country : US
Telephone Number : 702-636-4060
Fax Number :
Provider Business Practice Location Address
First Line : 916 W OWENS AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-2516
Country : US
Telephone Number : 702-653-3661
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2006
Last Update Date : 07/08/2007

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