Provider Demographics
NPI:1396703716
Name:KURNIK, PETER B (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:B
Last Name:KURNIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1601 CHERRY ST
Mailing Address - Street 2:SUITE 11511
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1321
Mailing Address - Country:US
Mailing Address - Phone:215-255-7822
Mailing Address - Fax:215-255-7825
Practice Address - Street 1:219 N BROAD ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-1519
Practice Address - Country:US
Practice Address - Phone:215-762-5080
Practice Address - Fax:215-561-8071
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2007-08-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD035712E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA053426Medicare PIN
PAC53895Medicare UPIN