Provider Demographics
NPI:1063734044
Name:KRZYSZTOF TUNIA MD LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:KRZYSZTOF TUNIA MD LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KRZYSZTOF
Authorized Official - Middle Name:
Authorized Official - Last Name:TUNIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-253-2065
Mailing Address - Street 1:54 PLAUDERVILLE AVE
Mailing Address - Street 2:SUITE NUMBER 1
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-2252
Mailing Address - Country:US
Mailing Address - Phone:973-253-2065
Mailing Address - Fax:973-253-2067
Practice Address - Street 1:54 PLAUDERVILLE AVE
Practice Address - Street 2:SUITE NUMBER 1
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-2252
Practice Address - Country:US
Practice Address - Phone:973-253-2065
Practice Address - Fax:973-253-2067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06844300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7801408Medicaid
G83388Medicare UPIN
NJ7801408Medicaid