Provider Demographics
NPI:1659356541
Name:KUNZE, GEORGE YOUNG (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:YOUNG
Last Name:KUNZE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 CLINTON AVE SOUTH
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-271-2800
Mailing Address - Fax:585-271-0375
Practice Address - Street 1:2080 CLINTON AVE SOUTH
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-271-2800
Practice Address - Fax:585-271-0375
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214640207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0231516OtherGHI
NY110208BTOtherPREFERRED CARE
NY000923207003OtherHEALTH NOW
P020214640OtherEXCELLUS
NY4V2821OtherEMPIRE
7920423OtherAETNA
NYP010214640OtherEXCELLUS
P00375709OtherRAILROAD MEDICARE
NY02377815Medicaid
NY2315026OtherINDEPENDENT HEALTH
NY0231516OtherGHI
NY4V2821OtherEMPIRE