MEDICARE: DR. CHERYL LYNNE KUNIS M.D.

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	207RN0300X	Nephrology Physician	127884	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669544938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERYL LYNNE KUNIS M.D.

Provider Business Mailing Address
First Line	:	214W 17TH ST 4A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-5346
Country	:	US
Telephone Number	:	212-729-6729
Fax Number	:	212-523-0498

Provider Business Practice Location Address
First Line	:	11E 26TH ST 1302
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10010-1432
Country	:	US
Telephone Number	:	646-438-9654
Fax Number	:	212-523-0498

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

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	09/20/2015

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