Provider Demographics
NPI:1982770582
Name:KUNKEL, MAUREEN H (MD)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:H
Last Name:KUNKEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 LULL WATER RD
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-2317
Mailing Address - Country:US
Mailing Address - Phone:203-261-2612
Mailing Address - Fax:
Practice Address - Street 1:14 LULL WATER RD
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-2317
Practice Address - Country:US
Practice Address - Phone:203-261-2612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT018245208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics