Provider Demographics
NPI:1649601733
Name:MIU, KUN
Entity Type:Individual
Prefix:
First Name:KUN
Middle Name:
Last Name:MIU
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 1:6 BAKER WAY
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1406
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6 BAKER WAY
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1406
Practice Address - Country:US
Practice Address - Phone:508-330-4193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-28
Last Update Date:2013-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor