Provider Demographics
NPI:1467570929
Name:HUNYADI, DENNIS A
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:A
Last Name:HUNYADI
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 1:1608 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-3170
Mailing Address - Country:US
Mailing Address - Phone:269-344-0202
Mailing Address - Fax:269-344-0285
Practice Address - Street 1:1608 LAKE ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-3170
Practice Address - Country:US
Practice Address - Phone:269-344-0202
Practice Address - Fax:269-344-0285
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301002484103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION33180Medicare ID - Type Unspecified