Susan Jean Kucirka, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD031979E Issued in PA

Practice address

4110 Independence Drive
Suite 300
Schnecksville, PA 18078

Phone

(610) 769-4200

Fax

(610) 769-4204

NPI assigned

Mar 15, 2006

Last updated

Jul 29, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Dermatology of the Lehigh Valley PC

  • Dermatology Physician
  • Schnecksville, PA
  • NPI 1669444139
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280361600000",
    "number": "1245209063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 INDEPENDENCE DRIVE",
            "address_2": "SUITE 300",
            "city": "SCHNECKSVILLE",
            "state": "PA",
            "postal_code": "18078",
            "telephone_number": "610-769-4200",
            "fax_number": "610-769-4204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 INDEPENDENCE DRIVE",
            "address_2": "SUITE 300",
            "city": "SCHNECKSVILLE",
            "state": "PA",
            "postal_code": "18078",
            "telephone_number": "610-769-4200",
            "fax_number": "610-769-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCIRKA",
        "first_name": "SUSAN",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2010-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD031979E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanne Klitsch
• Jessica Korba
• Jill Allison Kostenbader, MA
• Susan E Kostenblatt, MD
• Elizabeth Fox Kressin, MA, CCC-SLP/L
• Ryan Kunkle, ATC
• Andrea Laczo, M.S.
• Sandip Ladani, D.M.D.
• Erica Laudermilch, MA, CCC-SLP
• Le Grand Associates Inc

• Dermatology Physician in Schnecksville, PA
• Providers in Schnecksville, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.