Provider Demographics
NPI:1649853268
Name:HENLY, KURT AUSTIN (DPM)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:AUSTIN
Last Name:HENLY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PARKINSONS RD
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-8087
Mailing Address - Country:US
Mailing Address - Phone:848-224-5221
Mailing Address - Fax:
Practice Address - Street 1:3 PARKINSONS RD
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-8087
Practice Address - Country:US
Practice Address - Phone:848-224-5221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-02
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC007193213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery