Provider Demographics
NPI:1164526844
Name:GUNIA, RANDY EDWARD (OD)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:EDWARD
Last Name:GUNIA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 NEW MAIN ST
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-3808
Mailing Address - Country:US
Mailing Address - Phone:914-965-5367
Mailing Address - Fax:914-965-7601
Practice Address - Street 1:300 CONGRESS ST STE 201
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-0907
Practice Address - Country:US
Practice Address - Phone:617-471-5665
Practice Address - Fax:617-471-7041
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.009877152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist