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Individual

DR. MARRICK L KUKIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
158 E 84TH ST, NEW YORK, NY 10028-2005
(212) 535-6340
Mailing address
130 E 77TH ST, NEW YORK, NY 10075-1851
(212) 535-6340

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA10015100
NJ
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
155618
NY
207RC0000X
Cardiovascular Disease Physician
155168
NY
207RC0000X
Cardiovascular Disease Physician
Primary
25MA10015100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01105820
NY
Enumeration date
08/25/2005
Last updated
05/01/2024
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