Provider Demographics
NPI:1235568759
Name:BUNZEY, DEBORAH (CERTIFIED LAB TECH)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:BUNZEY
Suffix:
Gender:F
Credentials:CERTIFIED LAB TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 MELONDY HILL RD
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:NY
Mailing Address - Zip Code:13730-2244
Mailing Address - Country:US
Mailing Address - Phone:607-226-8733
Mailing Address - Fax:607-639-3244
Practice Address - Street 1:715 MELONDY HILL RD
Practice Address - Street 2:
Practice Address - City:AFTON
Practice Address - State:NY
Practice Address - Zip Code:13730-2244
Practice Address - Country:US
Practice Address - Phone:607-226-8733
Practice Address - Fax:607-639-3244
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2024-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33D2064447291U00000X
NY230602000168343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Yes291U00000XLaboratoriesClinical Medical Laboratory