Provider Demographics
NPI:1982056107
Name:KUNER, MARTIN (LCSW)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:KUNER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 PARIS CIR
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1130
Mailing Address - Country:US
Mailing Address - Phone:973-900-4727
Mailing Address - Fax:
Practice Address - Street 1:268 GREEN VILLAGE RD
Practice Address - Street 2:
Practice Address - City:GREEN VILLAGE
Practice Address - State:NJ
Practice Address - Zip Code:07935-3027
Practice Address - Country:US
Practice Address - Phone:973-900-4727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056157001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ902482OtherHORIZON BCBS