Provider Demographics
NPI:1528392032
Name:BUNN, ALLEN JOSEPH (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:JOSEPH
Last Name:BUNN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 323
Mailing Address - Street 2:619 RTE 539
Mailing Address - City:CREAM RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08514-0323
Mailing Address - Country:US
Mailing Address - Phone:609-758-4726
Mailing Address - Fax:609-758-6123
Practice Address - Street 1:619 ROUTE 539
Practice Address - Street 2:
Practice Address - City:CREAM RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08514-2334
Practice Address - Country:US
Practice Address - Phone:609-758-4726
Practice Address - Fax:609-758-6123
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01529000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist