Provider Demographics
NPI:1831113612
Name:DUNNER, RICARDO ORLANDO (MD,MPH)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:ORLANDO
Last Name:DUNNER
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 MIDLAND AVE APT 1E
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-6454
Mailing Address - Country:US
Mailing Address - Phone:718-809-4921
Mailing Address - Fax:212-202-4921
Practice Address - Street 1:20124 43RD AVE FL 2
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2545
Practice Address - Country:US
Practice Address - Phone:718-809-4921
Practice Address - Fax:212-202-4921
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204900207RA0401X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY019364388Medicaid
NY204900OtherLICENSE
NY204900OtherLICENSE
NY019364388Medicaid