Individual
DR. MARK KUTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
13711 73RD TER, FLUSHING, NY 11367-2303
(718) 575-3510
(718) 575-0391
Mailing address
13711 73RD TER, FLUSHING, NY 11367-2303
(718) 575-3510
(718) 575-0391
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
008766-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01365255
—
NY
01
—
P3098817
OXFORD
NY
01
—
V851X
EMPIRE BLUE CROSS
NY
Enumeration date
12/04/2006
Last updated
07/09/2007
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