Basic Information
Provider Information
NPI: 1205034956
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KUHTA
FirstName: ANNA
MiddleName: MARIE
NamePrefix: MRS.
NameSuffix:  
Credential: CCI
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 17392 KEY LIME BLVD
Address2:  
City: LOXAHATCHEE
State: FL
PostalCode: 334702912
CountryCode: US
TelephoneNumber: 7862719770
FaxNumber:  
Practice Location
Address1: 140 NUTT RD
Address2:  
City: PHOENIXVILLE
State: PA
PostalCode: 194603906
CountryCode: US
TelephoneNumber: 6109831000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/04/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
246W00000X00012869FLY Technologists, Technicians & Other Technical Service ProvidersTechnician, Cardiology 

No ID Information.


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