Provider Demographics
NPI:1831379742
Name:KUHNAU, TRICIA
Entity type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:
Last Name:KUHNAU
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TRICIA
Other - Middle Name:
Other - Last Name:DREPAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PNP
Mailing Address - Street 1:1400 PELHAM PKWY S
Mailing Address - Street 2:ROOM 807
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1138
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3424 KOSSUTH AVE
Practice Address - Street 2:PEDIATRIC ED
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-519-3015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF381920-1363LP0200X
NY381920363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics