Healthcare Provider Details

I. General information

NPI: 1144182908
Provider Name (Legal Business Name): RUTH ANN KUNIK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 SHENANGO ST STE 5
GREENVILLE PA
16125-2060
US

IV. Provider business mailing address

90 SHENANGO ST STE 5
GREENVILLE PA
16125-2060
US

V. Phone/Fax

Practice location:
  • Phone: 440-293-5555
  • Fax: 440-293-6643
Mailing address:
  • Phone: 440-293-5555
  • Fax: 440-293-6643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA066843
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberOA007347
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: