Provider Demographics
NPI:1770571622
Name:KUNIN, JOSHUA D (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:D
Last Name:KUNIN
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1625 STRAITS TPKE
Mailing Address - Street 2:SUITE #301
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1836
Mailing Address - Country:US
Mailing Address - Phone:203-573-9512
Mailing Address - Fax:203-568-2904
Practice Address - Street 1:1625 STRAITS TPKE
Practice Address - Street 2:SUITE #302
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-1836
Practice Address - Country:US
Practice Address - Phone:203-568-2929
Practice Address - Fax:203-568-2921
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT027692208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
E89704Medicare UPIN