Provider Demographics
NPI:1750658597
Name:GUNNIA, KARTHIK (PSYD)
Entity Type:Individual
Prefix:
First Name:KARTHIK
Middle Name:
Last Name:GUNNIA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 W 57TH ST
Mailing Address - Street 2:SUITE 912
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2802
Mailing Address - Country:US
Mailing Address - Phone:855-767-7287
Mailing Address - Fax:646-687-7893
Practice Address - Street 1:57 W 57TH ST
Practice Address - Street 2:SUITE 912
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2802
Practice Address - Country:US
Practice Address - Phone:855-767-7287
Practice Address - Fax:646-687-7893
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY019998103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical