Provider Demographics
NPI:1801960885
Name:KUNEC AND LAYUG LLP
Entity type:Organization
Organization Name:KUNEC AND LAYUG LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-604-3228
Mailing Address - Street 1:PO BOX 1264
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20725-1264
Mailing Address - Country:US
Mailing Address - Phone:301-604-3228
Mailing Address - Fax:301-604-0073
Practice Address - Street 1:11055 LITTLE PATUXENT PKWY
Practice Address - Street 2:SUITE L1
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2896
Practice Address - Country:US
Practice Address - Phone:410-740-7030
Practice Address - Fax:410-740-7033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD24388174400000X
MDD47363174400000X
MDD41258174400000X
MDD50349174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD699718000Medicaid
MD125M049FMedicare ID - Type Unspecified
MD125M050FMedicare ID - Type Unspecified
MD200026502Medicare UPIN
MD1309360003Medicare NSC
MD125M048FMedicare ID - Type Unspecified
MD699718000Medicaid