Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 040386 | NY |
NPI | 1013015643 |
---|---|
Provider Name | Dr. Marc Kunin |
First Address | Brooklyn, NY 11220-2508 |
Second Address | Brooklyn, NY 11220-2508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/01/2013 |