Provider Demographics
NPI:1619437001
Name:BUNIAK, NICHOLAS BORYS (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:BORYS
Last Name:BUNIAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5112 W TAFT RD STE H
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-4991
Mailing Address - Country:US
Mailing Address - Phone:315-452-3235
Mailing Address - Fax:315-452-5726
Practice Address - Street 1:5112 W TAFT RD STE H
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-4991
Practice Address - Country:US
Practice Address - Phone:315-452-3235
Practice Address - Fax:315-452-5726
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320094207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine