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Individual

CHARLES KUTLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
360 WASHINGTON AVR, KINGSTON, NY 12401-5144
(845) 338-7140
(845) 338-7141
Mailing address
360 WASHINGTON AVE, KINGSTON, NY 12401-3702
(845) 338-7140
(845) 338-7141

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
211804
NY
207RI0200X
Infectious Disease Physician
53630
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02361677
NY
Enumeration date
05/16/2006
Last updated
03/30/2020
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