Provider Demographics
NPI:1902879752
Name:KURIAN, DAMIAN C (MD)
Entity Type:Individual
Prefix:
First Name:DAMIAN
Middle Name:C
Last Name:KURIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 LENOX AVE
Mailing Address - Street 2:MLK 15-101
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1802
Mailing Address - Country:US
Mailing Address - Phone:212-939-4701
Mailing Address - Fax:212-939-4712
Practice Address - Street 1:506 LENOX AVE
Practice Address - Street 2:MLK 15-101
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1802
Practice Address - Country:US
Practice Address - Phone:212-939-4701
Practice Address - Fax:212-939-4712
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235073207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02645256Medicaid
634P31Medicare ID - Type Unspecified
I29620Medicare UPIN