Healthcare Provider Details

I. General information

NPI: 1275819922
Provider Name (Legal Business Name): LYNN NAYONA CUNADO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2011
Last Update Date: 08/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 SUMMER ST UNIT 101
STAMFORD CT
06905-5150
US

IV. Provider business mailing address

1515 SUMMER ST UNIT 101
STAMFORD CT
06905-5150
US

V. Phone/Fax

Practice location:
  • Phone: 203-323-8171
  • Fax: 203-323-7122
Mailing address:
  • Phone: 203-323-8171
  • Fax: 203-323-7122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA08798500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number268149
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number54469
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: