Provider Demographics
NPI:1013372069
Name:CUNEGIN, IRVIN
Entity Type:Individual
Prefix:
First Name:IRVIN
Middle Name:
Last Name:CUNEGIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8006 ORCHARD PARK WAY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4601
Mailing Address - Country:US
Mailing Address - Phone:301-275-4124
Mailing Address - Fax:
Practice Address - Street 1:701 HOWARD RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7101
Practice Address - Country:US
Practice Address - Phone:202-610-4193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-17
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist