Provider Demographics
NPI:1053617753
Name:CUNHA PODIATRY GROUP
Entity type:Organization
Organization Name:CUNHA PODIATRY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CUNHA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:202-253-6122
Mailing Address - Street 1:1132 CLINTON ST
Mailing Address - Street 2:APT 614
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-3249
Mailing Address - Country:US
Mailing Address - Phone:202-253-6122
Mailing Address - Fax:
Practice Address - Street 1:1132 CLINTON ST
Practice Address - Street 2:APT 614
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-3249
Practice Address - Country:US
Practice Address - Phone:202-253-6122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00303600213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty