Provider Demographics
NPI:1215905781
Name:KUTSCHMAN, DANIEL ANTHONY (DC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ANTHONY
Last Name:KUTSCHMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WHITE RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739
Mailing Address - Country:US
Mailing Address - Phone:732-530-4088
Mailing Address - Fax:732-530-4841
Practice Address - Street 1:200 WHITE RD
Practice Address - Street 2:SUITE 111
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739
Practice Address - Country:US
Practice Address - Phone:732-530-4088
Practice Address - Fax:732-530-4841
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00233700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ461753Medicare ID - Type Unspecified