Provider Demographics
NPI:1619906427
Name:CUNNINGHAM-RUNDLES, CHARLOTTE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:
Last Name:CUNNINGHAM-RUNDLES
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GUSTAVE L LEVY PLACE
Mailing Address - Street 2:BOX 3000 MOUNT SINAI DEPARTMENT OF MEDICINE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-987-3100
Mailing Address - Fax:212-731-5210
Practice Address - Street 1:5 E 98TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6501
Practice Address - Country:US
Practice Address - Phone:212-241-0764
Practice Address - Fax:212-534-0971
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108611207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
679852Medicare ID - Type Unspecified
B17857Medicare UPIN