Provider Demographics
NPI:1356604656
Name:HUNT, KIMBERLY DENISE (MSED)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:DENISE
Last Name:HUNT
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1666 LEE ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1220
Mailing Address - Country:US
Mailing Address - Phone:516-872-7375
Mailing Address - Fax:
Practice Address - Street 1:1666 LEE ST
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-1220
Practice Address - Country:US
Practice Address - Phone:516-872-7375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY648065174400000X
NY309048091174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist