Provider Demographics
NPI:1760053490
Name:KURACK, KEVIN ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ROBERT
Last Name:KURACK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-206-4765
Mailing Address - Fax:856-325-4796
Practice Address - Street 1:728 MARNE HWY STE 100B
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3128
Practice Address - Country:US
Practice Address - Phone:856-206-4765
Practice Address - Fax:856-325-4796
Is Sole Proprietor?:No
Enumeration Date:2021-07-03
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT2228832084P0800X
NJ25MA126033002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty