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Individual
JON C KUCERA
Active
Individual
JON C KUCERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
178475-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010096302
UNIVERA
NY
01
—
000510823004
BC/BS
NY
05
—
01139880
—
NY
01
—
040426002977
FIDELIS
NY
01
—
0409803
INDEPENDENT HEALTH
NY
01
—
150520-BJ
PREFERRED CARE
NY
01
—
2593447
GHI PPO
NY
01
—
72676
GHI HMO
NY
Enumeration date
10/11/2006
Last updated
03/02/2012
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