Provider Demographics
NPI:1225796436
Name:BUNO, ELAINE I (APN)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:I
Last Name:BUNO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:I
Other - Last Name:BUNO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ELAINE IVY BUNO
Mailing Address - Street 1:355 MERCER LOOP
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3234
Mailing Address - Country:US
Mailing Address - Phone:201-912-5203
Mailing Address - Fax:
Practice Address - Street 1:355 MERCER LOOP
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3234
Practice Address - Country:US
Practice Address - Phone:201-912-5203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-04
Last Update Date:2021-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01210500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily