1306813159 NPI number — ADAM KUNIN MD

Table of content: ADAM KUNIN MD (NPI 1306813159)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306813159 NPI number — ADAM KUNIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KUNIN
Provider First Name:
ADAM
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306813159
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
528 WASHINGTON HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORRISVILLE
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05661-8973
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-888-8338
Provider Business Mailing Address Fax Number:
802-888-8203

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
528 WASHINGTON HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORRISVILLE
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05661-8973
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-888-8338
Provider Business Practice Location Address Fax Number:
802-888-8203
Provider Enumeration Date:
03/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  0420009339 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RC0000X , with the licence number: 2275281 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: 81383 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 030349278 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 030349278 . This is a "VT MANAGED CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 030349278 . This is a "ONE HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 030349278 . This is a "USAA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 030349278 . This is a "LETTER CARRIES" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00048142 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 030349278 . This is a "UNITED AMERICAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: OVN1433 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01689225 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 030349278 . This is a "PRINCIPAL LIFE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 030349278 . This is a "ORVIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: DD5321 . This is a "NY MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01689225 . This is a "NY MEDICAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 030349278 . This is a "WAUSAU" identifier . This identifiers is of the category "OTHER".
  • Identifier: 030349278 . This is a "UNICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 030349278 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 479P21 . This is a "BCBS EMPIRE" identifier . This identifiers is of the category "OTHER".




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