Provider Demographics
NPI:1437775111
Name:KUNES, KELSEY NICOLE
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:NICOLE
Last Name:KUNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BAKERS HILL RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493-1708
Mailing Address - Country:US
Mailing Address - Phone:516-695-3850
Mailing Address - Fax:
Practice Address - Street 1:15 BAKERS HILL RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-1708
Practice Address - Country:US
Practice Address - Phone:516-695-3850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant