MEDICARE: DR. MICHAEL ALAN KUKFA MD

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	207R00000X	Internal Medicine Physician	175129	NY

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	:	1790753473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ALAN KUKFA MD

Provider Business Mailing Address
First Line	:	10 HAGEN DR
Second Line	:	SUITE 350
City	:	ROCHESTER
State	:	NY
Zip	:	14625-2660
Country	:	US
Telephone Number	:	585-385-5555
Fax Number	:	585-385-5611

Provider Business Practice Location Address
First Line	:	10 HAGEN DR
Second Line	:	SUITE 350
City	:	ROCHESTER
State	:	NY
Zip	:	14625-2660
Country	:	US
Telephone Number	:	585-385-5555
Fax Number	:	585-385-5611

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	02/19/2008

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