MEDICARE: DR. AMY KUNKLE D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	OS015310	PA

General Provider Information

NPI Number	:	1407134653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY KUNKLE D.O.

Provider Business Mailing Address
First Line	:	1320 EAST NORTH AVENUE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15212
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1320 EAST NORTH AVENUE
Second Line	:	SUITE 451 MELLON PAVILLION
City	:	PITTSBURGH
State	:	PA
Zip	:	15212
Country	:	US
Telephone Number	:	412-359-6726
Fax Number	:	412-688-7605

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2011
Last Update Date	:	07/21/2011

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