Provider Demographics
NPI:1730501008
Name:BUNAL, NORWIN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:NORWIN
Middle Name:
Last Name:BUNAL
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 ASPEN TER
Mailing Address - Street 2:
Mailing Address - City:NORTH HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-3128
Mailing Address - Country:US
Mailing Address - Phone:914-374-5657
Mailing Address - Fax:
Practice Address - Street 1:1 GUSTAVE LEVY PL
Practice Address - Street 2:BOX 1030, RM 655
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:914-374-5657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF306209363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health