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Individual

DR. MICHAEL JOHN KUTTNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D

Contact information

Practice address
990 SOUTH AVE, SUITE 210, ROCHESTER, NY 14620-2740
(585) 256-3440
Mailing address
448 WHITE SPRUCE BLVD, ROCHESTER, NY 14623-1608
(585) 256-3440

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
009564
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100295AH
PREFERRED CARE
NY
01
111980500
US DEPT OF LABOR
NY
01
P010009564
BLUE CHOICE
NY
01
P010009564
BLUE X/BLUE SHIELD
Enumeration date
06/25/2006
Last updated
04/28/2016
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