Provider Demographics
NPI:1023476223
Name:BUNNY, BRIAN SEAN
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:SEAN
Last Name:BUNNY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 RANSOMVILLE RD
Mailing Address - Street 2:
Mailing Address - City:RANSOMVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14131-9602
Mailing Address - Country:US
Mailing Address - Phone:716-791-3571
Mailing Address - Fax:716-791-3398
Practice Address - Street 1:3509 RANSOMVILLE RD
Practice Address - Street 2:
Practice Address - City:RANSOMVILLE
Practice Address - State:NY
Practice Address - Zip Code:14131-9602
Practice Address - Country:US
Practice Address - Phone:716-791-3571
Practice Address - Fax:716-791-3398
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker