Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 61821 | CT |
NPI | 1265666184 |
---|---|
Provider Name | Dr. John William Kunstman |
First Address | New Haven, CT 06510-3220 |
Second Address | New Haven, CT 06510-3220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2009 |
Last Update Date | 29/08/2018 |