MEDICARE: JOHN KUROVSKY OD

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
1	152W00000X	Optometrist	OEG000474	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447243282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN KUROVSKY OD

Provider Business Mailing Address
First Line	:	833 SCRANTON CARBONDALE HWY
Second Line	:
City	:	DICKSON CITY
State	:	PA
Zip	:	18519
Country	:	US
Telephone Number	:	570-343-8007
Fax Number	:	570-343-7311

Provider Business Practice Location Address
First Line	:	833 SCRANTON CARBONDALE HWY
Second Line	:
City	:	SCRANTON
State	:	PA
Zip	:	18508-1123
Country	:	US
Telephone Number	:	570-343-8007
Fax Number	:	570-343-7311

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	01/07/2008

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