Provider Demographics
NPI:1396725479
Name:KURLAND, KIMBERLY N (DO)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:N
Last Name:KURLAND
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4314 N GEORGE ST EXT'D
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:17345-1307
Mailing Address - Country:US
Mailing Address - Phone:717-266-0252
Mailing Address - Fax:717-266-6908
Practice Address - Street 1:4314 N GEORGE ST EXT'D
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:PA
Practice Address - Zip Code:17345-1307
Practice Address - Country:US
Practice Address - Phone:717-266-0252
Practice Address - Fax:717-266-6908
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007797L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001751263Medicaid
PA039846OtherGROUP PTAN
PAF82023Medicare UPIN
PA080186912Medicare PIN
PA039846OtherGROUP PTAN