Provider Demographics
NPI:1518418342
Name:KUNIN, LIDIA ZOFIA (LMSW)
Entity type:Individual
Prefix:
First Name:LIDIA
Middle Name:ZOFIA
Last Name:KUNIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 E 82ND ST APT 6A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7157
Mailing Address - Country:US
Mailing Address - Phone:917-837-0932
Mailing Address - Fax:
Practice Address - Street 1:1 GUSTAVE LEVY PLACE
Practice Address - Street 2:BOX 301C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-8462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091100-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker