Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 276574 | NY |
NPI | 1245468321 |
---|---|
Provider Name | Dr. Michael Kuncewitch |
First Address | Merrick, NY 11566-5228 |
Second Address | Cold Spring Harbor, NY 11724-2436 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2009 |
Last Update Date | 07/03/2019 |