Provider Demographics
NPI:1366968703
Name:KUTINSKY, JOSHUA KARL (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:KARL
Last Name:KUTINSKY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 N 71ST ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2306
Mailing Address - Country:US
Mailing Address - Phone:610-742-4936
Mailing Address - Fax:
Practice Address - Street 1:1528 WALNUT ST STE 1500
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3611
Practice Address - Country:US
Practice Address - Phone:215-735-2505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-17
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS0174962084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology