Provider Demographics
NPI:1922171065
Name:TUNIA, KRZYSZTOF STANISLAW (MD)
Entity Type:Individual
Prefix:DR
First Name:KRZYSZTOF
Middle Name:STANISLAW
Last Name:TUNIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 PLAUDERVILLE AVE
Mailing Address - Street 2:SUITE # 1
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-2252
Mailing Address - Country:US
Mailing Address - Phone:973-253-2065
Mailing Address - Fax:973-253-2067
Practice Address - Street 1:54 PLAUDERVILLE AVE
Practice Address - Street 2:SUITE # 1
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-2252
Practice Address - Country:US
Practice Address - Phone:973-253-2065
Practice Address - Fax:973-253-2067
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06844300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7801408Medicaid
NJ7801408Medicaid
NJ021619Medicare ID - Type Unspecified