Provider Demographics
NPI:1720176993
Name:KUNIEGEL, RON WILLIAM (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MR
First Name:RON
Middle Name:WILLIAM
Last Name:KUNIEGEL
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:746 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1624
Mailing Address - Country:US
Mailing Address - Phone:570-348-7100
Mailing Address - Fax:570-348-7696
Practice Address - Street 1:746 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1624
Practice Address - Country:US
Practice Address - Phone:570-348-7100
Practice Address - Fax:570-348-7696
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA051897363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical