Provider Demographics
NPI:1609856319
Name:TUNESKI, JEAN PEPIN (MS)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:PEPIN
Last Name:TUNESKI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:ANNETTE
Other - Last Name:PEPIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:324 FLANDERS RD
Mailing Address - Street 2:PO BOX 597
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1735
Mailing Address - Country:US
Mailing Address - Phone:860-739-1864
Mailing Address - Fax:860-739-5440
Practice Address - Street 1:324 FLANDERS RD
Practice Address - Street 2:
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1735
Practice Address - Country:US
Practice Address - Phone:860-739-1864
Practice Address - Fax:860-739-5440
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000210231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN