Provider Demographics
NPI:1922187525
Name:KUTSCHMAN, DAVID R (DC,CA)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:KUTSCHMAN
Suffix:
Gender:F
Credentials:DC,CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 SYCAMORE AVENUE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4218
Mailing Address - Country:US
Mailing Address - Phone:732-747-5022
Mailing Address - Fax:732-747-5822
Practice Address - Street 1:494 SYCAMORE AVENUE
Practice Address - Street 2:SUITE 205
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4218
Practice Address - Country:US
Practice Address - Phone:732-747-5022
Practice Address - Fax:732-747-5822
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00194700111N00000X
NJ25MZ00022900171100000X
NY001852-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3067106Medicaid
NJ3067106Medicaid