Individual
SERGEY KUNKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 444-0650
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 444-0650
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
S5000
TX
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
213458
NY
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
S5000
TX
Other
Enumeration date
10/19/2006
Last updated
12/03/2021
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