Kristian Kunicky (NPI# 1528096237, PAC ID# 3678501608) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1528096237 |
| PAC ID by PECOS | 3678501608 |
| Professional Enrollment ID | I20081210000236 |
| Full Name | Kristian Kunicky |
| Organization Legal Name | LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC |
| Address |
1364 Martin Blvd Suite 5 Middle River MD 21220-4104 |
| Phone Number | 4106861056 |
| Gender | M |
| Credential | PA |
| Graduation Year | 2001 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4385787910 |
| Number of Group Practice Members | 43 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 210009 | JOHNS HOPKINS HOSPITAL, THE |
| Address | Phone | Organization |
|---|---|---|
| 4940 Eastern Ave, Baltimore, MD 21224-2735 | JOHNS HOPKINS UNIVERSITY | |
| 600 N Wolfe St, Baltimore, MD 21287-0005 | JOHNS HOPKINS UNIVERSITY | |
| 600 N Wolfe St, Blalock 266, Baltimore, MD 21287-0005 | 4105024340 | JOHNS HOPKINS UNIVERSITY |
| 1364 Martin Blvd, Suite 5, Middle River, MD 21220-4104 | 4106861056 | LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC |
| 1364 Martin Blvd, Middle River, MD 21220-4104 | 4106861056 | LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC |
| Organization Legal Name | LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC |
| Physicians | 39 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dennis Albert Elwell | Physical Therapy | Lifebridge Sports Medicine and Rehabilitation LLC | 8757 Mylander Ln, Towson, MD 21286-2102 |
| Dontese J Nicholson | Interventional Pain Management | Lifebridge Sports Medicine and Rehabilitation LLC | 1364 Martin Blvd, Suite 5, Middle River, MD 21220-4104 |
| Joseph M Layug | Orthopedic Surgery | Lifebridge Sports Medicine and Rehabilitation LLC | 6190 Georgetown Blvd, Suite 108, Eldersburg, MD 21784-6460 |
| Leonard Allison Richardson | Internal Medicine | Lifebridge Sports Medicine and Rehabilitation LLC | 19 Walker Ave, Suite 100, Pikesville, MD 21208-4006 |
| Peggy R Posey | Physical Therapy | Lifebridge Sports Medicine and Rehabilitation LLC | 1393 Progress Way, Suite 907, Eldersburg, MD 21784-6473 |
| Monique Husbands Oyeukwu | Family Medicine | Lifebridge Sports Medicine and Rehabilitation LLC | 6190 Georgetown Blvd, Suite 108, Eldersburg, MD 21784-6460 |
| Chad C Zooker | Orthopedic Surgery | Lifebridge Sports Medicine and Rehabilitation LLC | 19 Walker Ave, Suite 100, Pikesville, MD 21208-4006 |
| Florin I. Niculescu | Rheumatology | Lifebridge Sports Medicine and Rehabilitation LLC | 6190 Georgetown Blvd, Suite 108, Eldersburg, MD 21784-6460 |
| Neal Brian Zimmerman | Orthopedic Surgery | Lifebridge Sports Medicine and Rehabilitation LLC | 826 Washington Rd, Suite 111, Westminster, MD 21157-5779 |
| Joseph Ciotola | Orthopedic Surgery | Lifebridge Sports Medicine and Rehabilitation LLC | 6190 Georgetown Blvd, Suite 108, Eldersburg, MD 21784-6460 |
| Street Address |
1364 MARTIN BLVD SUITE 5 |
| City | MIDDLE RIVER |
| State | MD |
| Zip | 21220-4104 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dontese J Nicholson | Interventional Pain Management | Lifebridge Sports Medicine and Rehabilitation LLC | 1364 Martin Blvd, Suite 5, Middle River, MD 21220-4104 |
| Sam W Serafi | Rheumatology | Lifebridge Sports Medicine and Rehabilitation LLC | 1364 Martin Blvd, Suite 5, Middle River, MD 21220-4104 |
| Carla A Crosby | Physical Therapy | Lifebridge Sports Medicine and Rehabilitation LLC | 1364 Martin Blvd, Suite 5, Middle River, MD 21220-4104 |
| Dina Alison Serfas | Physical Therapy | Lifebridge Sports Medicine and Rehabilitation LLC | 1364 Martin Blvd, Suite 5, Middle River, MD 21220-4104 |
| Steven Shinsky | Physical Therapy | Lifebridge Sports Medicine and Rehabilitation LLC | 1364 Martin Blvd, Suite 5, Middle River, MD 21220-4104 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Madelyn E Keese | Physical Therapy | 11605 Crossroads Cir, Middle River, MD 21220-2865 | |
| Jordan A Shettle | Physical Therapy | Evolution Sports Physiotherapy - White Marsh LLC | 11605 Crossroads Cir, Middle River, MD 21220-2865 |
| Edwin E Pimentel-brugal | Internal Medicine | Health Md LLC | 11560 Crossroads Cir, Suite 106, Middle River, MD 21220-2885 |
| Manuel E. Perez Bonnelly | Internal Medicine | Health Md LLC | 11560 Crossroads Cir, Suite 106, Middle River, MD 21220-2885 |
| Chinwe M Okudo | Nurse Practitioner | 107 Beacon Rd, Baltimore, MD 21220-3504 | |
| Chienyenwa E Nwachinemere | Internal Medicine | 201 Ballard Ave, Middle River, MD 21220-3656 | |
| Dave A Adeleye | Nurse Practitioner | 611 Tinker Rd, Middle River, MD 21220-3773 | |
| Irene W Njuguna | Nurse Practitioner | Optimize Medical Group | 1300 Windlass Dr, Oakwood Care Center, Middle River, MD 21220-4126 |
| City | MIDDLE RIVER |
| Zip Code | 21220 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | MIDDLE RIVER + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Kristian Kunicky.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.