MEDICARE: CHRISTIE MARIE KUNA FNP

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	207Q00000X	Family Medicine Physician	F3349531	NY
2	363LF0000X	Family Nurse Practitioner	0017139005	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C06695	OTHER	VA	MEDICARE GROUP PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	C05700	OTHER	VA	GROUP PTAN
4	C09633	OTHER	VA	GROUP PTAN
5	C06778	OTHER	VA	GROUP PTAN

General Provider Information

NPI Number	:	1801808506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIE MARIE KUNA FNP

Provider Business Mailing Address
First Line	:	632 BROADWAY PH 12
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10012-2614
Country	:	US
Telephone Number	:	347-294-3414
Fax Number	:

Provider Business Practice Location Address
First Line	:	632 BROADWAY PH 12
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10012-2614
Country	:	US
Telephone Number	:	347-294-3414
Fax Number	:

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

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	08/31/2022

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