Provider Demographics
NPI:1669449716
Name:KUNICKY, CORIN (PT)
Entity Type:Individual
Prefix:
First Name:CORIN
Middle Name:
Last Name:KUNICKY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CORIN
Other - Middle Name:
Other - Last Name:ESTEROWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2608 BERWYN CT
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4675
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1820 OLD CUTHBERT RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1414
Practice Address - Country:US
Practice Address - Phone:856-216-0382
Practice Address - Fax:856-216-0835
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ40QA01063500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist