Healthcare Provider Details

I. General information

NPI: 1992859839
Provider Name (Legal Business Name): KUNEC AND LAYUG LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 01/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14201 LAUREL PARK DR SUITE 111
LAUREL MD
20707-5203
US

IV. Provider business mailing address

14201 LAUREL PARK DR SUITE 111
LAUREL MD
20707-5203
US

V. Phone/Fax

Practice location:
  • Phone: 301-604-3225
  • Fax: 301-604-0073
Mailing address:
  • Phone: 301-604-3225
  • Fax: 301-604-0073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD50349
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD24388
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD41258
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD47363
License Number StateMD

VIII. Authorized Official

Name: DR. JERRY THOMAS
Title or Position: MD
Credential:
Phone: 301-604-3228