Provider Demographics
NPI:1013741701
Name:KUENN PHOTO & VIDEO, LLC
Entity type:Organization
Organization Name:KUENN PHOTO & VIDEO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA, OWENER
Authorized Official - Prefix:
Authorized Official - First Name:LEIGHANN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUENN
Authorized Official - Suffix:
Authorized Official - Credentials:DOULA
Authorized Official - Phone:860-334-0812
Mailing Address - Street 1:11 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:PAWCATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06379-2201
Mailing Address - Country:US
Mailing Address - Phone:860-334-0812
Mailing Address - Fax:
Practice Address - Street 1:11 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:PAWCATUCK
Practice Address - State:CT
Practice Address - Zip Code:06379-2201
Practice Address - Country:US
Practice Address - Phone:860-334-0812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KUENN PHOTO & VIDEO, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty